Preamble

The House met at Eleven o'Clock

PRAYERS

[Mr. SPEAKER in the Chair]

PRIVATE BUSINESS

LONDON COUNTY COUNCIL (WOOLWICH SUBSIDENCES) BILL [Lords]

Read the Third time, and passed, with Amendments.

NORWICH EXTENSION BILL [Lords]

WISBECH CORPORATION BILL [Lords]

As amended, considered; to be read the Third time.

BUSINESS OF THE HOUSE

Lieut.-Colonel Elliot: May I ask the Deputy-Leader of the House if he has any statement to make about the Business for Wednesday?

The Secretary of State for the Home Department (Mr. Ede): Yes, Sir. The subjects for debate on Wednesday next, the 24th allotted Supply Day, will be as follows: Opencast coal till seven o'clock, and afterwards the European Payments Union. It was originally intended to take the Debate on the European Payments Union in the first half of the day, but at the Government's request it is being taken in the second part of the day, to enable my right hon. Friend the Minister of State for Economic Affairs, who is to attend an international conference, to be in his place. We are obliged to the Opposition for making that arrangement for his convenience. The document which has been promised with regard to the European Payments Union will be in the Vote Office on Monday evening.

Orders of the Day — MAINTENANCE ORDERS BILL [Lords]

As amended (in the Standing Committee), considered.

Clause 2.—(JURISDICTION OF ENGLISH SUMMARY COURTS TO MAKE ORDERS FOR CUSTODY AND MAINTENANCE OF INFANTS.)

11.7 a.m.

The Secretary of State for the Home Department (Mr. Ede): I beg to move, in page 2, line 23, to leave out from "Acts." to "by," in line 24.
I suggest that it would be convenient to consider at the same time the next Amendment, in line 26. These are drafting Amendments designed to cure a possible ambiguity pointed out by the hon. Member for Wolverhampton, South-West (Mr. Powell) during the Committee stage. I think that they will remove any doubt.

Amendment agreed to.

Further Amendment made: In line 26, at end, insert:
for an order relating to the custody of an infant (including, in the case of proceedings by the mother, an order requiring the father to make payments to the mother towards the infant's maintenance)."—[Mr. Ede.1]

Clause 16.—(APPLICATION OF PART II.)

Mr. Ede: I beg to move, in page 8, line 36, after "made," to insert "or deemed to be made."
Again, it would be for the convenience of the House to consider at the same time the next Amendment, in line 38.
The enactments named in the first three paragraphs of subsection (2, a) are being consolidated. These Amendments substitute for references to the enactments at present in force references to the consolidating Measure. The Matrimonial Causes Bill provides that it shall come into force on 1st January, 1951—the same day as this Bill.

Mr. Manningham-Buller: Is there any precedent for altering a Bill in this way by inserting a reference to a Matrimonial Causes Act, 1950. when there is no such Act and when, judging from experience we have had recently, it may well be that when a consolidating Bill comes before this House,


though it is a consolidation Measure, it may bear a different title? We have had recent experience of consolidating a lot of Acts in the Diplomatic Privileges (Extension) Bill, and the consolidating Measure has borne a title which did not correspond with them at all. Is there any precedent in this House for amending a Bill by inserting references to an Act of Parliament which is not yet an Act and which may not become an Act under that title at all?

Mr. Ede: By leave of the House, may I say that I have a precedent in my own legislative experience with regard to the Licensing Bill, which passed through this House, and in which a reference was made to the Justices of the Peace Bill, which also passed this House. On that occasion, while it is true that it was not a consolidation Measure, it was passed by both Houses and received the Royal Assent. In the event of it being found that the other Measure is not likely to go through, we shall endeavour in another place to have inserted such Amendments to these House of Commons Amendments as will provide that the position may be rectified.

Amendment agreed to.

Further Amendment made: In page 8, line 38 to leave out from beginning, to end of line 4, page 9, and insert—
(i) sections nineteen to twenty-seven of the Matrimonial Causes Act, 1950."—[Mr. Ede.]

Mr. Ede: I beg to move, in page 9, line 38, after "under," to insert "or by virtue of."
I think it might be for the convenience of the House if we discussed this Amendment and the next four Amendments together. The effect of the first three Amendments is to bring within Part II of the Bill, as has been done in this case of the corresponding jurisdiction of the High Court in England, maintenance orders made by the High Court in Northern Ireland by virtue of jurisdiction inherited from the ecclesiastical courts. Such jurisdiction was preserved in the High Court by Section 28 of the Matrimonial Causes Act (Northern Ireland), 1939. An example of such an order is an interim order for alimony made in a case of judicial separation. The fourth Amendment, that to line 16, is a drafting Amendment of a transitional nature.

Amendment agreed to.

Further Amendments made: In page 9, line 42, leave out "or."

In line 42, after "twenty-two," insert
or subsection (1) of section twenty-eight.

In page 10, line 15, leave out from "section," to end of line 16, and insert
twenty-three of the Matrimonial Causes Act, 1950.

In line 16, at end, insert:
(3) For the purposes of this section any order made before the commencement of the Matrimonial Causes Act (Northern Ireland), 1939, being an order which, if that Act had been in force, could have been made under or by virtue of any provision of that Act, shall be deemed to be an order made by virtue of that provision.—[Mr. Ede.]

Clause 17.—(PROCEDURE FOR REGISTRATION OF MAINTENANCE ORDERS.)

Mr. John Hay: I beg to move, in page 10, to leave out lines 22 and 23.
I suggest that it would be for the convenience of the House if we discussed along with this Amendment the two following Amendments in my name—in page 10, line 26, to leave out from "magistrate," to end of line 27, and in line 29, to leave out "which made the order."
When the Bill was before the Standing Committee, I raised a point on Clause 17 that provision should be made in the Bill that a wife who had obtained a maintenance order in any particular court and had later moved to another part of the country, should not necessarily have to go back to the court which originally made the order to carry out the registration procedure. I received the impression from the right hon. Gentleman, when he was dealing with that point in the Standing Committee, that he would consider it favourably, but in fact I have not heard anything from him, except a very courteous letter which he wrote to me, in which he pointed out that this matter might be dealt with by rules of court.
I feel that it is a great hardship upon a woman who has obtained an order and then moved to another part of the country that she should have to go back many miles to the original court which made the order to apply for registration, when it might easily be done in a far more simple manner. That is the purpose of my Amendment.

Mr. Higgs: I beg to second the Amendment.
I do not think it is generally appreciated that the Bill enables the proceedings to follow the husband or the person who makes application to the court to the place to which he has moved, but that it does not assist the wife in any way by enabling her to apply to the court in the place to which she has moved. It is for that purpose that I support this Amendment.

11.15 a.m.

The Lord Advocate (Mr. John Wheatley): The principle which guided us in framing this Clause was the desire to allow the court which made the order to deal with the application, but we quite appreciate that there might be the practical difficulties which the hon. Member for Henley (Mr. Hay) has indicated and which might impose a certain amount of hardship to the wife. Therefore, we then applied our minds to the question of how best to get over that difficulty, and I think the hon. Gentleman admits that he did receive a letter from my right hon. Friend the Home Secretary indicating the line which we propose taking.
We think that the best course for the purpose of dovetailing the two positions is to leave it to the court which made the order, but by rules of court to enable the wife to make application by letter, if need be, so that she will not be required to make the journey from the area in which she is then residing to the area of the court, if those two areas are in different places. In some later Amendments, we have provided for the making of statutory declarations, and I think that by the combination of these factors we can leave the application to the court which made the order to deal with any practical difficulties which might occur. I do not think it will be desirable to accept the alteration proposed in the Amendment to the course which we have suggested.

Mr. Hay: On that assurance from the right hon. and learned Gentleman, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Mr. Ede: I beg to move, in page 11, line 7, to leave out from "registration," to the end of line 8, and to insert:
in the prescribed manner to the prescribed officer of the court which made the order.

(5) The officer to whom any notice is given under the last foregoing subsection shall cause particulars of the notice to be registered in his court in the prescribed manner.
This Amendment is really one of a series of Government Amendments to the Bill which have been put down as the result of a re-examination of Part II of the Bill arising from points made by the hon. Member for Henley (Mr. Hay) in Committee. The purpose of this series of Amendments is threefold. First, to make it clear beyond doubt that the manner of giving notice may be prescribed by rules; secondly, to place upon the officer of the court who receives such notice a duty to enter particulars of the notice in the official record of the court; and thirdly, to ensure, in the case of summary maintenance orders, that proof is available as required of the content of the order, and of the fact that it is or is not registered in another part of the United Kingdom. I hope that the Amendments, of which this is really the first, meet the points made by the hon. Gentleman, and will also make the administration of the Bill more clear to those who will be affected by it.

Mr. Hay: I am extremely grateful to the Home Secretary for taking up the points which I put forward in Committee. I have looked at these Amendments, and I think they admirably meet the points which I had in mind.

Amendment agreed to.

Clause 23.—(NOTICE OF VARIATION, ETC.)

Mr. Ede: I beg to move, in page 15, line 27, to leave out "to that effect," and to insert
of the variation in the prescribed manner.
I think this Amendment and the next two Amendments could be conveniently taken together, as they form part of the series of Government Amendments to which I have already referred. They make the corresponding provision in relation to the notice of variation to that made in relation to notice of registration by the Amendment which we have already made in page 11, line 7.

Amendment agreed to.

Further Amendments made: In page 15, line 32, leave out "to that effect," and insert:
of the discharge or variation in the prescribed manner.

In line 33, at end, insert:
(3) The officer to whom any notice is given under this section shall cause particulars of the notice to be registered in his court in the prescribed manner."—[Mr. Ede.]

Clause 24.—(CANCELLATION OF REGISTRATION.)

Mr. Ede: I beg to move, in page 15, line 34, to leave out from the beginning, to "cancel," in line 38, and to insert:
At any time while a maintenance order is registered under this Part of this Act in any court, an application for the cancellation of the registration may be made in the prescribed manner to the prescribed officer of that court by or on behalf of the person entitled to payments under the order; and upon any such application that officer shall (unless procedings for the variation of the order are pending in that court).
As at present drawn, subsection (1) gives a person entitled to payments made under an order registered in a court in another part of the United Kingdom an absolute right to have the registration cancelled. This would mean that a person entitled to payments could block any proceedings in the court of registration on the part of the person liable to payments for a variation in the rate of the payments by having the registration cancelled before those proceedings have been completed. This Amendment is designed to remedy this defect by providing that registration shall not be cancelled while any proceedings for variation are pending in the court in which the order is registered.

Amendment agreed to.

The Lord Advocate: I beg to move, in page 16, line 10, to leave out "to that effect," and to insert:
of the cancellation in the prescribed manner.
With permission, perhaps this Amendment and the next one—page 16, line 11—might be taken together. These two Amendments form part of a series of Amendments to which my right hon. Friend has already referred. They make corresponding provision in relation to notice of cancellation of registration to that already made in relation to notice of registration by the Amendment previously dealt with in Clause 17, page 11, line 7.

Amendment agreed to.

Further Amendment made: In page 16, line 11, at end insert:
and the last-mentioned officer shall cause particulars of the notice to be registered in his court in the prescribed manner."—[The Lord Advocate.]

Clause 25.—(RULES AS TO PROCEDURE OF COURTS OF SUMMARY JURISDICTION.)

The Lord Advocate: I beg to move, in page 16, line 35, to leave out "proceedings before."
I think it would be convenient if we took this Amendment and the next three Amendments together, because they all deal with the same subject matter. This Amendment and that in page 16, line 41, are designed to make • it clear that the rule-making power is not confined to the regulation of the practice to be followed in proceedings, but covers things to be done in a court of summary jurisdiction prior to or where no proceedings are actually pending before the court; for instance, the action to be taken by the clerk of the justices who receives notice that an order made in his court, but for the time being registered in another court, has been varied according to the rates of payment. This is a drafting Amendment to ensure that it covers not only proceedings in the court, but cases where proceedings may not actually be before the court.
The purpose of the Amendments in page 16, line 36, and page 16, line 42, is to delete some superfluous words, and I think these Amendments will commend themselves to the House. The words in the Clause as it stands at present, which give power to the Lord Chancellor in England and to the Lord Chief Justice in Northern Ireland to prescribe in the rules anything that requires to be prescribed, are unnecessary in view of the definition of "prescribe" in Clause 28, which is to the same effect. Accordingly, we seek to cut out these superfluous words.

Amendment agreed to.

Further Amendments made: In page 16, line 36, leave out from "Act," to end of line 38.

In line 41, leave out "proceedings before."

In line 42, leave out from "Act," to end of line 44.—[The Lord Advocate.]

The Lord Advocate: I beg to move, in page 16, line 44, at the end, to insert:
(3) Rules made for the purposes of this Part of this Act may require that any order or other matter required under this Part of


this Act to be registered in a court of summary jurisdiction in England or Northern Ireland shall he registered—

(a) in England, by means of a memorandum entered and signed by the prescribed officer of the court in the register kept pursuant to section twenty-two of the Summary Jurisdiction Act, 1879;
(b) in Northern Ireland, by means of an entry made and signed by the prescribed officer of the court in the order book kept pursuant to Section twenty-one of the Petty Sessions (Ireland) Act, 1851.

The purpose of some of the earlier Amendments of this same series was to provide that when the prescribed officer of court receives notice of any matter under Part II of the Bill, he shall record it in a manner prescribed by rule. This Amendment ensures, in relation to summary courts in England and Northern Ireland, that the rule shall provide that the particulars of the notice are recorded in the register of the appropriate court in accordance with the normal practice.

Amendment agreed to.

Clause 26.—(PROOF OF DECLARATIONS, ETC.)

The Lord Advocate: I beg to move, in page 17, line 5, to leave out from "summary," to "shall," in line 7, and to insert:
made for the purposes of this Act or of any rules made thereunder.
This Amendment is really designed to meet a point raised by the hon. Member for Henley (Mr. Hay) in Committee when he suggested that Clause 17 should enable application for the registration of an order under Part II of the Bill to be made in the court having jurisdiction in the place where the person entitled to payment resides. As I said earlier, it was considered that there was a valid point in his argument, but that we could meet it better by providing in the rules that application could be made by letter, supported possibly by a statutory declaration. The result is that, although the application will still have to be made to the court which made the order, it will not be necessary for the person to attend personally at that court.
Clause 26, which provides that statutory declarations and other documents shall be deemed without further proof to be the documents which they purport to be, applies only to statutory declarations made under Part II of the Bill.

A statutory declaration to support a written application for registration will be made not under the Act, but under the rules, and accordingly this Amendment is designed to apply Clause 26 to such declarations.

Amendment agreed to.

The Lord Advocate: I beg to move, in page 17, line 11, at the end, to add:
(2) Paragraph 7 of the Second Schedule to the Emergency Laws (Miscellaneous Provisions) Act, 1947 (which relates to the proof of affiliation orders and maintenance orders and of orders for the discharge or variation of such orders), shall apply to the registration of orders under Part II of this Act, and to the cancellation of such registration, as it applies to the variation of orders; and for the purposes of that paragraph

(a) a maintenance order registered under the said Part II in a court of summary jurisdiction; and
(b) any proceeding under the said Part 11 relating to a maintenance order made by or registered in such a court, being a proceeding of which a memorandum is required to be entered in the register kept by the clerk of that court pursuant to section twenty-two of the Summary Jurisdiction Act, 1879,

shall be deemed to he an order made by that court.
This is the last of the series of Amendments with which we have been dealing. Its purpose is to ensure, in the case of a maintenance order made by an English court of summary jurisdiction, that proof is available when required both of the content of the order and of the fact that it is or is not registered, as the case may be. This Amendment effects that purpose by attracting and adapting the provisions of paragraph 7 of the Second Schedule to the Emergency Laws (Miscellaneous Provisions) Act, 1947, relating to the proof of maintenance orders.

Amendment agreed to.

Motion made, and Question proposed. "That the Bill be now read the Third time."

11.27 a.m.

Mr. Manningham-Buller: As this Bill owes its origin to such a large extent to the efforts made from this side of the House, it would be a pity to depart from it without saying a few words of farewell. I think all hon. Members will agree that it is a very desirable Measure, but I must say that in my opinion it contains one


defect which is likely to give rise to considerable trouble in operation in the future. That defect, unfortunately, I understand, remains in the Bill to soothe Scottish susceptibilities. It is one which we sought to eliminate in the Committee stage, and it has certainly been lessened in degree by the Amendment made during that stage. But, in certain cases under the Bastardy Laws (Amendment) Act, under the National Assistance Act, and under the Children Act, 1948, jurisdiction of the English courts and of the Scottish courts will depend upon where an act of intercourse took place. This is something quite novel, and I do not believe that it will work well in practice.
Usually, before a court comes to hear and determine the issues in the case, it is enabled to decide whether it has jurisdiction to hear and to determine the case at all. But under this Bill; when certain proceedings are brought under those Acts, a court of summary jurisdiction will not know whether it has any jurisdiction at all until the conclusion of the complete trial. If, in a disputed case, the complainant alleges that an act of intercourse took place in this country, and the respondent denies it—and, indeed, may establish that it took place north of the Border—then whether or not the court makes an order against the respondent will depend whether they come to the conclusion that the act of intercourse took place north or south of the Border.
They will only make the order if they come to the conclusion that it took place south of the Border, and so they will only resolve the question whether they have jurisdiction or not at the very conclusion of the trial. I think this departure from the previous practice is likely to cause considerable difficulty; and I do not think it will be very long, notwithstanding the objections which have been raised from another part of the United Kingdom, before we shall have to have an amending Measure eliminating this one difficulty in the Bill. I do not believe that it serves any practical purpose.
I am sorry that the Government have not been able to accept the Amendment which was moved in Committee to delete this condition, which is an important condition affecting jurisdiction in these cases. I cannot think of any case in the courts of this country when,

at the end of the day when all the evidence has been heard, the court may say, "It has not been established to our satisfaction that the respondent is the guilty man and, therefore, we must, while deciding that, decide also that we have no jurisdiction at all in the case." The court might have been engaged on the hearing for one or two or more days, and then find they have no jurisdiction whatsoever to hear it.
It seems to me a most extraordinary position, which will result in considerable difficulties in some of the courts of the country. After all, magistrates, quite rightly, are very careful to see that they do not act in excess of the jurisdiction they have. If they do act in excess of their jurisdiction, they may be visited with certain penalties. Now, in this category of cases, they will not know whether they have jurisdiction or not until the conclusion of the case. It seems to me to be wrong, and not to serve any useful purpose.
I hope that by making this comment on what I believe is the one remaining defect in this Bill, I shall not be thought to be departing, in any way, from the main purposes of the Bill, and from the welcome we have extended to it throughout, with our efforts to improve it. We take the view that this Bill will meet a want which has been long felt. We hope it will work well. We feel it would have been certain of working better if the Amendment we moved had been accepted.

Mr. Hay: When this Bill was read a Second time, it received general approval from all quarters. I believe that now, as we take leave of it, it is in a form better adapted to carry out in an expeditious manner the purpose for which it was intended. However, I should like to emphasise again the point my hon. and learned Friend the Member for Northants, South (Mr. Manningham-Buller) has raised in connection with this provision relating to affiliation orders. It is still an unsatisfactory situation. During the proceedings in Standing Committee, we did our utmost to impress upon the Government that very serious difficulties would arise from the practical point of view. We can only regret that, even at this stage, they have not been able to see our point of view.
We are here making a Statute, and we have to bear in mind that, eventually, some parts of that Statute may come before the higher courts for decision. As it stands, Clause 1 of the Bill contains what I still consider to be an inaccuracy which is bound to cause a certain amount of dissatisfaction from the point of view of a superior court which might have to consider it eventually. In our view, the reference to residence together as man and wife, on which my hon. Friend the Member for Bromsgrove (Mr. Higgs) and myself had put down an Amendment, which has not been called, does introduce to our law an entirely new sort of expression. In Committee I said it would have been far better to say out and out "co-habitation between the parties," or some other expression which would make more clear what the Government had in mind. The Under-Secretary of State for the Home Department pointed out that what they had in mind was residence together by husband and wife, but it is not clear.
In our law we have this clear definition of co-habitation and all that it means. That has been clearly settled by the courts on many occasions. It is also clear what is meant by residence in a particular place by separate persons. Here we have the hybrid expression, "resided together as man and wife." I ask the Government to look at it again and consider what is meant, and what will be believed is meant by people who have to consider those words. This is a sort of half-way house between two well-established definitions, and it is something which is a blot on the Bill as it stands.
But, generally, the Measure is going to do a great deal to help a most deserving type of persons. We have done something to improve the law relating to maintenance orders and the unhappy circumstances that arise when man and wife fall out.

11.37 a.m.

Lieut.-Colonel Lipton: The hon. and learned Member for Northants, South (Mr. Manningham-Buller) has endeavoured once again to establish his claim, or that of his hon. Friends, to the paternity of this Measure. One can only wish that some of the people to be dealt with under this legislation were as

eager to accept paternal responsibility as hon. Members opposite have been eager to accept it for the Bill we are now discussing.
As has been pointed out already, it may well be that this new principle, of making the place of intercourse a factor in deciding jurisdiction, may give rise to some difficulties. It adds a new principle in the administration of the law in this aspect. But, as the Lord Advocate pointed out in the Committee Stage, the difficulties may not be as great as have been anticipated by hon. Members opposite. In any event, it will he for the complainant to be very careful before deciding to take action in a particular court; because the complainant will not wish to prejudice a claim by seeking to take proceedings in a court if she is not going to be in a position to establish, fairly conclusively, that the act of intercourse relating to the birth of a child took place within the area of the jurisdiction of that particular court.
The main advantage of this Bill is that it will make a little more worth-while the mass of separation and maintenance orders that are being churned out in the courts up and down the country. Unfortunately, in the past, some of these have not been worth the paper on which they are written. This Bill is to be welcomed to the extent that it makes some of these orders imposable. There is still a yawning gap in the administration of the law in this matter in the British Isles. Normally, a person has only to go to the Republic of Ireland, and nothing we are discussing can possibly apply. I hope that, some time, it may be possible to stop up that particular gap, which may operate very harshly in a number of cases. Nevertheless, this Bill has proceeded fairly happily through all its stages, and we all wish it well on the Statute Book.

11.40 a.m.

Mr. Higgs: I should like to say one word in support of the point raised by the hon. Member for Henley (Mr. Hay) on Clause 1. We are introducing here, so far as my research goes, a phrase new to our statute law:
residing together as man and wife.
It is, I believe, a well-established rule that, in a field like this which has been the subject of so much litigation, when a new phrase appears in the statute, the courts feel obliged to find a new meaning for it.
As has been said, the courts have thoroughly defined the state of affairs known as cohabitation, and there is no doubt, apparently, as to what is involved in residing at the same address. I read in this morning's paper that a man and wife resided at the same address in such a state of estrangement that they erected a screen between them when eating their meals. Here we have a state of affairs midway between the two conditions I have indicated. I hope that we may be able, before we bid farewell to this Bill, to know exactly what these words are intended to convey.
There is one other point to which I should like to refer. It relates to Clause 20 and to the extent of arrears of maintenance which may have accrued during the time when a husband living in Scotland has not been making payments. This Bill, for the first time, makes provision for enforcing these payments, and, therefore, one has to look carefully, as the Bill does, to these arrears, which may be very substantial. Provision is made in Clause 20 (3) for a court in Scotland to have a discretion as to whether it will or will not remit the arrears. I think that we have to bear in mind in practice—those of us who practise in the courts in this sort of case that where a court has a discretion to exercise, it will require to hear evidence before it will exercise that discretion.
The position in this country is that if a husband wants the arrears remitted he must go to the court and give evidence why they should be remitted. In Scotland under this Clause the position will be reversed. If the wife does not want them remitted, she will have to go and explain why they should not be remitted. We have gone to the trouble in this Bill to remove the gearing, as it were, to the place where the husband lives. A husband is present in Scotland in circumstances envisaged in this Clause. The husband is the person who has a court on the doorstep. The hearing takes place, and yet it is the wife who has to satisfy the court before it will exercise its discretion and keep alive the arrears. I say that that will be a hardship in practice, because it will mean that, if the wife wants to keep long arrears alive and seeks to enforce them in the future, she will lose the whole benefit of this Bill unless she goes to Scotland to explain why she wishes to do so.
I had hoped that at some stage in these proceedings, the Government would have been persuaded to view it in that light. It does arise in practice, and the courts do insist on hearing evidence before they will exercise their discretion, and we should have preferred the evidence which they would require to hear, to be that of the husband, which is the conventional procedure on the subject, and not that of the wife who might have to travel a long distance. These are matters of detail and do not derogate from the general welcome which we give to the Bill.

11.44 a.m.

Lieut.-Commander Clark Hutchison: I should like to express my pleasure that the Bill has got to its final stage in this House. I have been interested in this matter for nearly nine years, as a result of a case in my own constituency of which the Lord Advocate is aware. I hope that the intentions of the Bill will be carried out. Frankly, not being a lawyer, I do not like to express an opinion on the technical points raised by the hon. and learned Member for Northants. South (Mr. Manningham-Buller) and the hon. Member for Henley (Mr. Hay). I think that the broad purpose of the Bill is admirable, and I hope that it will bring relief and assistance to a great many women who have had a very rough deal in the past.

11.45 a.m.

Lieut.-Colonel Hyde: In adding my word of farewell to the Bill, I should like to say on behalf of hon. Members representing Northern Ireland constituencies on this side of the House, that we think that the Bill is now in better state than it was on Second Reading. We should have preferred it, if the Amendment moved by the hon. and learned Member for Northants, South (Mr. Manningham-Buller) and supported by the hon. Member for Henley (Mr. Hay), affecting Clause 3, had been accepted, but, apart from that, we think that this is an excellent Measure and that it will bring relief to people by whom it is much needed.

11.46 a.m.

The Secretary of State for the Home Department (Mr. Ede): I should like to thank the House for the reception which they have given to this Measure, and for


the way in which on the Committee stage and this morning we have had co-operation from both sides of the House, in a non-party spirit, in an endeavour to improve it. I never apologise for the fact that Amendments have been accepted or introduced into a Bill during its passage through this House, because that is what the House and the various stages of the proceedings are designed to secure.
I agree with the hon. and gallant Member for Belfast, North (Lieut.-Colonel Hyde) that the Measure is a better Measure now than it was when it was brought from another place to this House. I am bound to say that I do not share the view expressed by the hon. and learned Member for Northants, South (Mr. Manningham-Buller) about the origin of the Bill. It is true that it had been talked of for a long time, and one of the first things that I did when I took office was to see if something could be done to make a determined legislative effort to deal with the subject. I was not greatly helped in that matter by any heritage of documents left by the party opposite when they were in office.
Undoubtedly, we did come across a conflict of opinion between English and Scottish lawyers, and we have had to enshrine the result in this Bill. I would point out to the hon. and learned Member one of the curious things that happened during the Committee stage when, in his absence, the hon. Member for Kingston-upon-Thames (Mr. Boyd-Carpenter) was most gallantly and efficiently leading the Opposition party. The case for the English practice was very well argued, but when it came to the Division we had the curious experience that the two Scottish Members of the Opposition declined to vote, and, in that way, I think, indicated that while, of course, they would not vote against their party they could not support them.
I had the humiliation of having the hon. Member for Coatbridge and Airdrie (Mrs. Mann), who can always be relied upon in such circumstances to place the representative of the Government in as uncomfortable a position as she can, not only speaking against me but having the pluck to vote against me. Fortunately, the Committee rejected the Amendment moved by the Opposition by, I think, 20 votes to 14, which is quite

a good majority for these days even on the Floor of the House, and is, of course, simply overwhelming when it is secured in Committee.
Personally, I regret that the victory of Bannockburn should have been repeated on this occasion. If the hon. and learned Gentleman can arrange a Flodden Field in the future, I am not at all sure that I should not feel that there was a very great deal to be said for the line of argument he adopted, but, at any rate, we have managed, I think without doing any substantial injustice, to ensure that a certain number of scoundrels who on both sides of the border have been evading their liability will in future be amenable to the courts of the country, and will not be able, merely by going north or south of the Tweed, to escape their liability. They will in future have to contribute what the law says they ought to contribute.
I am not going to enter into a new argument about the question of a man and wife living together. I thought that my hon. Friend the Under-Secretary gave a very able answer to that question during the Committee stage. I am not at all sure that the erection of a screen at breakfast time between the two parties is not almost proof that they are living as man and wife. I have heard complaints on occasions that the size of "The Times" at the breakfast table, when one is trying to discover what happened to the speech one delivered the previous day at the House, as constituting a barrier, can be regarded as almost a matrimonial offence.
The hon. Member for Bromsgrove (Mr. Higgs) raised the question of arrears. In my experience as a magistrate, the question of what should be done when substantial arrears have accumulated is very often a matter of great concern. It is often wondered whether the money will ever be got out of the man. On occasions, I think that the woman is well served when the accumulated arrears are wiped out or reduced and it is made quite clear to the man that arrears must not be allowed to accumulate in future.
There is the problem I dealt with in relation to the jurisdiction of the courts and the place where the matter has to be heard. I think we shall find that, in the long run, the position created by the Bill will help a good many women to get money they would not otherwise have


got. With the limited amount of knowledge we have on the future working of the Bill, I am not going to put it any higher than that. This is a Measure to which both sides have made a contribution. Perhaps, as viewed by the lawyers, some of it may not be very good law, but I believe that the whole of it is most excellent justice, which, after all, is what the House has attempted to achieve. I thank the House sincerely for the way in which the Bill has been treated.

Question put, and agreed to.

Bill accordingly read the Third time, and passed with Amendments.

COLONIAL AND OTHER TERRITORIES (DIVORCE JURISDICTION) BILL [Lords].

Considered in Committee.

[Major MILNER in the Chair]

Clause 1.—(EXTENSION OF PRINCIPAL ACTS TO PERSONS DOMICILED IN NORTHERN IRELAND.)

Motion made, and Question proposed, "That the Clause stand part of the Bill."

11.53 a.m.

Lieut.-Colonel Hyde: I should like to say a word on this Clause which makes the principal Acts applicable to Northern Ireland. I shall not trouble the Committee with the reasons why we welcome the Bill in Northern Ireland, because they were given during the Second Reading Debate. There is one point, however, which I should like to stress. It arises out of a remark I made during the Second Reading Debate which was taken up by the Attorney-General. I suggested that perhaps there had not been sufficient consultation between the appropriate authorities here and those in Northern Ireland as to the applicability of the Measure to Northern Ireland.
The Attorney-General affected to be somewhat shocked at my proposal that there should have been such consultations, because he suggested, in what I might describe as rather admonitory tones, that if that had been done, it would have meant going behind the back of the Government of Northern Ireland. It is perfectly clear now, from Section 47 of the Government of Ireland Act, 1920, that

all matters relating to the Supreme Court of Northern Ireland are reserved matters; that is to say, that the Northern Ireland Government have nothing to do with them from the administrative point of view, and that they come within the exclusive jurisdiction of the Government in this country.
I wish to emphasise that, in the opinion of my hon. Friends who represent Northern Ireland constituencies, it would not have been improper for consultation on the lines I have suggested to have taken place, particularly with the Bar of Northern Ireland. Apart from that observation, I wish to say that we welcome the Clause, which not only applies the Bill to Northern Ireland, but also applies the provisions of the 1926 to 1940 Acts, which we think will afford much needed relief to the individuals concerned who are domiciled in Northern Ireland.

Question put, and agreed to.

Clause ordered to stand part of the Bill.

Clauses 2 to 5 ordered to stand part of the Bill.

Clause 6.—(SHORT TITLE, CITATION AND INTERPRETATION.)

Motion made, and Question proposed, "That the Clause stand part of the Bill."

Lieut.-Colonel Lipton: May I ask a question which I raised during the Second Reading, namely, why are the words "Divorce Jurisdiction" in brackets, whereas in previous Acts relating to this matter the words are not put in brackets? Perhaps my right hon. and learned Friend has found out the reason for this by now.

The Attorney-General (Sir Hartley Shawcross): I am sure that it is common form. I do not pretend to understand all these drafting matters. but this is the way these Measures are commonly titled.

Mr. Manningham-Buller (Northants, South): Has a bracket any legal significance?

The Attorney-General: Well!

Question put, and agreed to.

Clause ordered to stand part of the Bill.

Bill reported, without Amendment.

Motion made, and Question proposed, "That the Bill be now read the Third timz."—[The Attorney-General.]

Mr. Manningham-Buller: We think this is a good Bill, complicated though it is. We hope that it will work extremely well in practice. I should like to stress, as I have stressed before, that as soon as possible we should have a consolidation Measure embodying all the Acts this Bill seeks to amend. Whether the Title of the consolidation Measure should include brackets or not, we can leave to further consideration.

Question put, and agreed to.

Bill accordingly read the Third time, and passed, without Amendment.

MISCELLANEOUS FINANCIAL PROVISIONS BILL

Motion made, and Question proposed, "That the Bill be read the Third time."—[Mr. Jar.]

11.59 a.m.

Colonel Crosthwaite-Eyre: I should like to ask one question which arises out of the previous Debate, namely, whether the Financial Secretary can say how much it is proposed to take from the Civil Contingencies Fund before such time as legislation is introduced, and whether such drawings will include both our initial payments by way of subscription and also our initial debit payments.

12 noon.

The Financial Secretary to the Treasury (Mr. Douglas Jay): I am afraid it is impossible to give a detailed answer to that question in terms of figures. Of course, in so far as we need to make advances before legislation effecting the European Payments Union is produced, we shall make use of the Civil Contingency Fund, as my right hon. and learned Friend explained in his recent statement, thereby confirming what was foreshadowed in the previous Debate. However, I am afraid it is impossible at this stage to determine what the amount will be, still less to make a precise public statement to the House. Of course, any amounts involved, together with the other liability, will be within the new total of the Fund.

Colonel Crosthwaite-Eyre: Would the hon. Gentleman answer the second part of the question, about including the initial debit amount?

Mr. Jay: It is not possible to foresee that precisely, but I think it is quite probable it will.

Question put, and agreed to.

Bill accordingly read the Third time, and passed.

LONDON GOVERNMENT BILL

Order read for Second Reading read.

12.2 p.m.

The Minister of Health (Mr. Bevan): This small but very useful Measure I hope will commend itself to all sections of the House. In the first report that was published last November, the Local Government Manpower Committee surveyed the whole field of the relations between local government and the central Government. Most of their recommendations have been put into operation administratively. The only one that requires legislation is that embodied in the Bill. It has been an anomalous position for some time that the Metropolitan Boroughs had to go to the Ministry of Health for certain loan sanctions and to the County Council for others. I know, and I think hon. Members of all parties have known, that the Metropolitan Boroughs have resented this for some years and the County Council has not been anxious to retain it.
It gives rise to confusion and sometimes to duplication. It is vexatious when the Metropolitan Boroughs get loan sanction from the County Council in certain cases and then have to go to the Ministry of Health for compulsory purchase. Therefore, it seems to us it would simplify the procedure; it would be more economical; and it would serve as an additional emollient, if it is required, between the Metropolitan Boroughs and the London County Council if the Metropolitan Boroughs came direct to the Ministry of Health for all loan sanctions. I do not think it is necessary for me to explain any further what is a very simple Measure.

12.3 p.m.

Mr. Henry Brooke: In relation to this Bill, I can speak in almost every relevant capacity, because I represent in this House a London borough, I am a member of its Borough Council and of the London County Council, and also, I think, I am the only Member


of the Local Government Manpower Committee who is also a Member of this House. So I am a sort of Pooh-Bah in this matter, but fortunately, like Pooh-Bah, I have found my responsibilities, at any rate on this occasion, in no degree inconsistent with one another, because I think this Bill is welcomed from all quarters.
I would not go so far as the Minister in suggesting that this has long been a matter of very serious resentment amongst the Metropolitan Boroughs. En the London County Council I remember, three years ago, my hon. Friend the Member for Lewisham, West (Mr. H. Price) criticising the existing system because the boroughs found that, since the war at any rate, when they applied to the London County Council for loan sanction for housing schemes, it was a slower business than applying to the Ministry of Health. They had a sneaking feeling that the rest of the local authorities of the country could get their applications granted or returned with the official comments more quickly from the Ministry than could the Metropolitan Boroughs from the London County Council.
The subject arose ultimately almost by a side wind in the deliberations of the Local Government Manpower Committee. The Minister will remember how that Committee, whose recommendations in its first Report he has accepted, made certain suggestions to simplify the whole system of loan sanction applications from local authorities generally. It would have been quite anomalous to adopt those general recommendations and to leave untouched the existing arrangements between the Metropolitan Boroughs and the London County Council, which unfortunately were laid down by Statute, so that they could not be altered without an amending Act.
The London County Council, I know, sees no objection to changing this procedure. Why should it? It saves some manpower, and in that respect, if in no other, it would be welcome to local authorities at the present time. The London Borough Councils, while welcoming the change in procedure, will also watch with hope and interest to see whether their expectations will be fulfilled, and whether the Ministry can give quicker service in this matter than the

London County Council has hitherto been able to do. I appreciate very much the decision not only to accept these recommendations but to put into operation the new system so expeditiously. I hope it will come into use from 1st October with the good wishes of all parts of the House.

Question put, and agreed to.

Bill accordingly read a Second time.

Committed to a Committee of the whole House Committed upon Monday next.—[Mr. Collindridge.]

MEDICAL BILL [Lords]

Considered in Committee.

[Colonel Sir CHARLES MACANDREW in the Chair]

Clause 1.—(FULL REGISTRATION IN MEDICAL REGISTER NOT TO BE GRANTED WITHOUT PROOF OF EXPERIENCE.)

Motion made, and Question proposed, "That the Clause stand part of the Bill."

12.8 p.m.

Lieut.-Colonel Elliot: I should like to know whether the Minister will be able to look favourably upon an Amendment which we have on the Order Paper at a later stage. Clause 1, of course, has been the subject of a great deal of comment and of correspondence with which all hon. Members, or at any rate those hon. Members with some medical qualifications, have been deluged. It seems to us that we could properly discuss many of these matters on the Amendment which we have to a further Clause, but I should not like to allow this Clause to go by default now without discussion, if it were held by the Minister and by you, Sir Charles, that these various points as to the certification should be dealt with here. It will be seen that in Clause 1 it is mentioned:
… it is certified under the next following section that he has had the experience specified in that section.
We consider that the question, which this Clause undoubtedly raises, would be more appropriately considered under the next Clause where the arrangements for making such a certificate are laid down. If the Minister would agree to that and if you, Sir Charles, would find it in order,


it seems to me that that course might be for the convenience of the Committee.

The Minister of Health (Mr. Bevan): I understand that the right hon. and gallant Gentleman has suggested that I should indicate the attitude of the Government towards certain Amendments to Clause 2, by which the Opposition seek to substitute an affirmative Resolution for the annulment procedure. There is an Amendment on the Order Paper to Clause 2, page 1, line 25, to which the Opposition attach some importance. The question which arises on that is whether the rules governing the intern are to be the subject of affirmative or negative Resolution. I understand that is the the point now put. I do not mind it being discussed, but I will say at once to the Opposition that I am extremely sympathetic to that Amendment. Although it is perfectly true that any hon. Member would always have the opportunity of putting down a Prayer to annul the Order, in this case, as we are starting something extremely novel and exceedingly important to the doctors, the House ought to have it even more in its possession. Therefore I am prepared to accept the Amendment to make it an affirmative Resolution.

Question put, and agreed to.

Clause ordered to stand part of the Bill.

Clause 2.—(CERTIFICATE OF EXPERIENCE IN APPROVED HOSPITAL.)

Sir Hugh Lucas-Tooth: I beg to move, in page 1, line 25, at the end, to insert:
(2) No order shall be made under subsection (1) of this section unless a draft thereof has been laid before Parliament and has been approved by resolution of each House of Parliament.
The right hon. Gentleman has just indicated the attitude of the Government to this Amendment, and we on this side of the Committee welcome what he has said. However, it is right that we should have some discussion on this, because it raises important matters of considerable interest outside this House. Clause 1 lays down the general principle that a doctor is not to start independent practice until he has had some experience. It states that in the most general terms, and it is apparent that hon. Members on both sides

of the Committee are in full agreement with that general principle.
Clause 2 provides the machinery by which that principle is to be carried into practice. Here we are on much more difficult ground. The Clause is not specific. For instance, it lays downs no precise period for intern service. I do not quarrel with that. Indeed, it is an Amendment made to the Bill in another place and it is right, on the whole, that the machinery provided by this Clause should be thoroughly flexible and capable of Amendment from time to time, in order to meet changing circumstances and to cover what experience may show.
There are, however, quite serious misgivings in various quarters as to how this change will operate in practice. The most obvious misgiving in this connection is that which all hon. Members have had communicated to them by those who are now actually in process of being medical students, who have entered the profession on the basis that they were to do five and a half years under instruction before they could begin to earn money, and now have some apprehension that they may have to do six and a half years.
12.15 p.m.
Unfortunately the hon. Member for Batley and Morley (Dr. Broughton) was not here to move his Amendment to Clause 1, page 1, line 18, so we have not been able to dispose of that point, but it would be helpful if the right hon. Gentleman would indicate when he expects this new arrangement will be brought into operation. It would be unfair to those who are now just about to finish their training to find that they have a long period still to go, so that if the Minister says he does not intend to bring this in for a year or two, it would go a long way to allay misgivings on that score.
Those interested in this matter from a rather different angle are concerned with the position of the hospitals. Are there enough house appointments to provide the further training which this part of the Bill contemplates? I have calculated that it will require three new appointments per group of hospitals. I am not sure whether that figure is accurate. There is misgiving in the medical profession that the effect of this will be to alter the quality of the work to be done by the men now filling house appointments.

The Deputy-Chairman (Colonel Sir Charles MacAndrew): I cannot follow the hon. Baronet. This Amendment deals only with affirmative Resolutions, surely?

Sir H. Lucas-Tooth: I have gone beyond the narrow terms of the Amendment, Sir Charles, but I was indicating to the Committee the kind of consideration we would have to bear in mind when the order to be made under this Amendment comes before the House.

Lieut.-Colonel Elliot: Further to that point of order, Sir Charles. It was with the object of having the discussion on this question arising out of Clause 1, that we waived the discussion on that Clause and got straight on to the point of the orders to be made. It was hoped by us that some wider discussion than the narrow one as to the orders might be in order in virtue of that arrangement.

Mr. Bevan: I have already indicated that I am prepared to accept the Amendment in substance, but as usual we would like to look at the words. I accept the purport of the Amendment, which is to make these orders subject to an affirmative Resolution. May I suggest, therefore, that we can dispense with the Amendment, which would not therefore cause trouble with the Chair, and have our discussion on the Question "That the Clause stand part of the Bill," because there is no other Amendment to this Clause.

Sir H. Lucas-Tooth: If that would meet the convenience of the Committee, I am perfectly willing to withdraw the Amendment and then to discuss the matter on the Question "That the Clause stand part of the Bill."

The Deputy-Chaiman: Is it the desire of the Committee that this Amendment be accepted?

Mr. Bevan: In substance, not in form—

Lieut.-Colonel Elliot: On that point, does the Minister indicate that he would wish to move on Report stage an Amendment embodying the affirmative Resolution, but in other words?

Mr. Bevan: Yes.

Lieut.-Colonel Elliot: In that case I think my hon. Friend should be pre-

pared to withdraw the Amendment, and accept the suggestion that a more general discussion should take place on the wider question of the Clause standing part.

The Deputy-Chairman: Perhaps the hon. Member will do that, and then we can carry on.

Sir H. Lucas-Tooth: I want to be quite certain that the general discussion can range over the two Clauses together. We have deferred the discussion on Clause 1, and it would he unfortunate if we could not discuss both Clauses together.

Mr. Bevan: I am in the hands of the Committee and of you, Sir Charles. I have not the slightest objection to the discussion on Clause 2 going as wide as is necessary to ventilate the points which have been raised.

The Deputy-Chairman: If it be the wish of the Committee, the discussion can be as wide as necessary on the Question "That the Clause stand part of the Bill."

Sir H. Lucas-Tooth: I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Mr. Bevan: I beg to move, in page 2, line 21, to leave out from "applicant," to the first "the," in line 23, and to insert
who has been engaged in medicine has also been engaged in surgery or in midwifery or both, or an applicant who has been engaged in surgery has also been engaged in midwifery.
This Amendment is intended to remedy an omission in the existing subsection, which, as it stands, provides for the way in which a doctor who engages during his intern service, in work which is a combination of medicine and surgery, or of medicine, surgery and midwifery, is to have that period of employment divided into so much time on medicine, surgery, and, where appropriate, midwifery, respectively. It makes no provision for the doctor who engages in work which combines only medicine and midwifery or surgery and midwifery. The Amendment ensures that the same arrangement shall operate in all three cases.
I have always been in a little difficulty about this, because it cannot be said that the intern is having proper experience if most of his experience is confined to a certain speciality. Therefore, it is necessary that there should be a proper


division of time over the whole of the work, in order that he might take full advantage of the intern service.
It has been put to me in several quarters that unless proper arrangements are made—and this is the reason we attach very great importance indeed to the inspection of hospitals where the intern service is given—an intern might be confined to certain beds in the hospital which are dedicated to only one speciality. It is essential, therefore, that his experience should be spread as far as possible and that arrangements be made for the spreading to be done.

Lieut.-Colonel Elliot: I think that the Amendment is reasonable. It is the first time that this question of the duties of the intern, which will of course be rather different from the duties of the houseman because they will be an integral part of the professional training necessary to obtain his certificate, has arisen; and I think it is a good thing that the Minister should have taken the step which he has done here.
We shall, of course, have to consider, both during the remaining proceedings on the Bill and later when the proposals of the Minister come up for affirmative Resolution, how the duties of the new intern are being worked out, because, as was pointed out on Second Reading, the intern is a new figure in our professional life, and in the hospital especially. It is certainly very necessary that he should have a wide general training and not merely specialist training which might easily happen if, for instance, he were in a ward connected with skin diseases. He might have six months' service exclusively on that, which would be of great importance if he were taking up that field of work later on, but might not be of any great advantage to him if he were trying to deliver a baby.

Amendment agreed to.

The following Amendment stood on the Paper in the name of Mr. SOMERVILLE HASTINGS: In page 2, line 26, at the end, to insert:
(5) Where physical disability renders an appointment in surgery or midwifery impossible the Council may accept an equivalent period of satisfactory service in medicine or in a health centre in lieu thereof.

Mr. Hastings: I think most of us would agree on the dangers of too early specialisation, and that however a doctor decides to specialise eventually, whether in administration, psychiatry, medicine or anything else, he ought to have a general knowledge of the background of medical practice and of the health needs of the people. Without this background he will not have the right perspective in the study and practice of whatever branch he decides to undertake.

Mr. Bevan: I think that my hon. Friend is perhaps concentrating on the wrong Amendment.

The Deputy-Chairman: The Amendment which I called was that to page 2, line 26.

Mr. Bevan: That is why I think that my hon. Friend is addressing his remarks to the next Amendment: In Clause 3, page 3, line 14, leave out paragraph (b).

Mr. Hastings: No, I am not.

Mr. Bevan: The Amendment we are discussing reads:
Where physical disability renders an appointment in surgery or midwifery impossible. …
I propose to accept this Amendment in principle. The next one, of course, is much wider.

Mr. Hastings: May I continue my argument in favour of the one we are discussing?

Mr. Bevan: I am accepting it.

Mr. Hastings: Thank you. Then I need not waste time in arguing the case.

Motion made, and Question proposed, "That the Clause, as amended, stand part of the Bill."

Commander Noble: I wish to refer for a moment to a point that would have been covered by the Amendment to Clause 1 in the name of the hon. Member for Batley and Morley (Dr. Broughton) which was not moved. I would like to draw attention to one group of people who are very worried about how the compulsory period of resident experience in hospitals will operate in practice.
I ask the Minister to consider particularly those whose medical studies were interrupted by the war, and especially those who, if they had not volunteered to join the Services during their medical training, would have qualified before the Bill comes into force. Many of these people are very keen to get into practice as soon as possible. They are older now than the age at which they would have qualified but for the interruption in their training; they probably have wives and families to support, and they are worried that they may be held up now for an unexpected period in hospital. I ask the Minister to bear this in mind. I fully realise the importance of the period of residence in hospital, but I hope that the Minister will make the whole scheme as flexible as possible, so that the particular group to which I have drawn attention will suffer as little hardship as possible.

Dr. Barnett Stross: As has already been pointed out, present-day students are a little disturbed, although perhaps unnecessarily, in that those who have already planned their lives, particularly those who are married, would find it difficult if there was to be separation or break-up of their domestic life in order to serve for a year inside a hospital. Although they are not many in number, I hope that my right hon. Friend will bear them in mind and give them an opportunity of opting out of this provision, which would, I think, meet their case.
12.30 p.m.
Apart from this, I think that students may be reassured on the effects of the Clause. After all, it offers them full employment at, I hope, a suitable rate of remuneration. Apart from the married men to whom I have referred they have not, therefore, a great deal to worry about. We have already had some reference by my hon. Friend the Member for Barking (Mr. Hastings)—and the Minister accepted his Amendment—to difficulties which might arise where men have physical disabilities. But this matter should be taken a little further than illness and physical disability. Not all medical students are quite alike, nor are they likely to find an equal amount of favour among those who might accept them. They may differ a little in stature, or in colour, and we ought to have some assurance that there is room for all of

them when this provision comes into force.
Not everyone wants to be fully registered forever in his life in the full sense to which we are referring. If a man has completed his medical studies and obtained his degree, he may wish to work as a physiologist for the remainder of his life, or to go on to biochemistry. He may never want to practise. If, however, he wanted to come back into practice he could do so by obeying the rule we are making. I hope the Minister will give an assurance that in all these cases where the man is going into a sister profession, he need not register fully.
I know it is not possible to get an actual definition of "satisfactory service." If my hon. Friend the Member for Warrington (Dr. Morgan) had been present a little earlier, I think he would have discussed this point quite fully. It may well be that the individual should have a right of appeal against a decision that his service was not satisfactory. If that were possible, I think hon. Members would agree. I have bitter memories of the time when I was a medical student. Our teachers are human beings after all and show some favouritism sometimes. I was a victim of favouritism, that is to say, I was favoured at times and other people did not like me so much and I was not favoured by them. Looking back on my career as a student, I wonder whether this provision is going to be quite fair to everybody. It means that if the person who is to sign a certificate, does not like the student, may be—I put it no higher—a little biased or prejudiced against him. Can we not insert a safeguard for the man who has registered and done his full year and asks for full registration, so that there should be some method by which he could say, "I do not think this is correct, I do not think this is justice?"

Mr. Linstead: The proposals for an intern year have been almost unanimously accepted as a wise addition to medical education by the informed section of the medical profession accustomed to deal with the training schools and medical education. At the same time, a large number of people in the medical profession, and some of the medical students, have failed to appreciate all that is involved in this matter. Many of them have false ideas of what the new proposals


will mean and I do not think the Committee would be wasting time this morning if we examined in some detail with the Minister what his intentions are and if, as a result of that examination, we cleared away some of the misunderstanding which appears to be giving rise to objections.
I have found the objections extremely well summarised in a letter which appeared in "The Times" yesterday, with no fewer than seven points. If the Minister finds it possible to deal with the bulk of those objections in a comprehensive statement I think it will be very well worth while and will clear the air a great deal. I shall mention some of those objections in order to provide an opportunity to whoever is replying for the Government. The letter deals with the point raised earlier by my hon. Friend the Member for Hendon, South (Sir H. Lucas-Tooth) on the possibility of this extra year being a breach of faith with existing medical students. I have no doubt the Minister has some period of time in mind before this is brought into operation, which will remove any suggestion that there is here a breach of faith. Nevertheless, I hope he will be able to say something authoritative about that.
The next point which is raised is that of the power given to prescribe the period of internship is a power with no limit. The writer of the letter said:
With the approval of the Privy Council the General Medical Council is empowered to extend indefinitely this period of tutelage.
I am quite certain that the answer to that is that both the Privy Council and the General Medical Council can be assumed to be responsible bodies who will not use the important power given to them in any callous way. Nevertheless, if the Minister can indicate that there is a limit of a year in his mind, it would remove that objection.
The next point is one to which I know students attach considerable importance. That is the question of satisfactory service. They want to know what their position will be if, after they have completed their qualifying examination and obtained provisional registration and served their intern year, a certificate of satisfactory service is refused them. Is there to be an appeal, or are they

completely at the mercy of the hospital or the qualifying body under whom this period of internship is served? Have they no redress if the certificate is refused?
Then there is the question of the standing of the men and women in the service. They will be provisionally registered; will that entitle them to sign death certificates within the institution in which they are serving their year? Will it entitle them to prescribe dangerous drugs? Those are the outward and visible signs of statutory recognition and I hope the Minister will make it clear that within the institution, they can do those things and that provisional registration gives them that status.
Linked with that is the question of remuneration. The Minister told the House during Second Reading that these young men and women are to be remunerated. Can he give some indication of the type of remuneration? Is it to be merely the pocket-money remuneration of the old house physician and house surgeon, or will it be sufficient to enable these people to live with some reasonable degree of freedom? There is also the question put in this letter and put, I think, by the British Medical Students' Association of what guarantee they have that there are enough jobs to go round. I agree with my hon. Friend the Member for Hendon, South, that there should be very little difficulty in getting three or four of these people into each of the hospital groups of the country. But some reassurance from the Minister on that point would be extremely useful and certainly there should be an indication that, until he knows the posts are there, he will not begin to impose this period of training.
There are two other points which I will mention. One is the application of the Bill to different parts of the country at different times. That can give rise to a certain amount of misunderstanding and indeed of heartburning amongst students. A man in Scotland may find that it takes him a year longer to become fully registered compared with a man in England. The Minister ought to expound a little his views on that provision of the Bill.
Finally, attention is drawn in the letter to the separation of the married student from his family during this extra year. This extra year puts on the Minister an


obligation to make certain that married quarters are available for any of these students who are married and who are so to speak confined to hospital for a whole year, with the possible breaking up of their family life. I have taken a good deal of time in elaborating these points because I know they are points which are misunderstood, and that it is well worth spending time over them. Any time that the Minister spends in making his intentions clear upon them will be time well spent.

Dr. Stross: I am sure that the hon. Member has not in mind the idea that students should take their wives with them into the hospital and that married quarters should be attached to the hospital? Will the hon. Gentleman say whether what he has in mind is that there should be available rooms reasonably near to the hospital where the students can live out, while they are working in the hospital?

Mr. Lenstead: What I have in mind is not the important consideration here. These are misgivings which are quite widely held and it is what the Minister has in mind which is the really important thing. That is what we want to find out today.

Dr. Broughton: I should like to apologise to you, Sir Charles, for not being in my place to move the Amendment to Clause 1 standing in my name when it was called. This Clause and Clause 1 are closely related, and perhaps I might refer to Clause 1 in a general way when speaking about Clause 2.

The Deputy-Chairman: It was arranged that there should be a wide Debate on Clauses 1 and 2 upon the Motion "That Clause 2, as amended, stand part of the Bill."

Dr. Broughton: I remember that when I was studying medicine I had a fellow-student about 15 years older than myself. He was in Holy Orders and desired to go abroad into the field of missionary work. He wished to be able to give his attention to the physical as well as to the spiritual needs of the people. He had saved just enough money to be able to afford a medical education, he thought that he could spare just that amount of time. I am pleased to add that he achieved his ambition, he qualified in

medicine and became registered, and I have no doubt that he is at present abroad doing most useful work in attending to the physical and spiritual needs of people. But if an additional period of time, even six months let alone a year, had been imposed whilst he was in training it would have wrecked his plans.
I hope, therefore, that the Minister of Health will give most careful consideration to the cases of hardship that may arise if this Clause is left without some amendment at a later stage. I said during the Second Reading Debate on this Bill that I wholeheartedly supported the suggestion that there should be a period of intern work after qualification. I repeat that. I can see the benefits that will flow from it, but I fear that there may be injustice inflicted in a few cases unless students are granted the right of appeal against it. When I say students I mean present students. Reference has already been made to the correspondence which has appeared recently in "The Times." Those letters state the case of the present-day students quite clearly, and I hope that the Minister of Health has read them.
12.45 p.m.
I have been approached by a medical student who is a retired barrister. I can give an indication of his age by informing the Committee that he will draw his postwar credit very soon. He wishes to spend the remainder of his life as a medical missionary in India. He tells me that if he has to put in an extra year's work of intern duties after qualification all his plans will be upset. He told me that had he known before he began his medical training that it would be necessary for him to spend seven years on the course he would not have started.
I have given just a few examples of the type of cases in which injustice may be suffered if Clauses 1 and 2 remain as they are. I hope that the Minister of Health will allow some Amendments at a later stage. Had I the eloquence of the Minister of Health, I feel that I could make a moving appeal for those students who might suffer hardship under the present provisions of the Bill. I have tried to put the case for them as best I can, and I hope that the justice of my claim has been understood. I would inform the Minister that the British Medical Students Association desire that all present medical students should be


exempted from the provisions of Clause 1 and Clause 2. He will fail to satisfy them unless he grants that. My own view is that it would be unnecessary to go so far, but I hope that some right of appeal will be allowed in respect of those who would suffer by the operation of the Bill as it stands at present.

Surgeon Lieut.-Commander Reginald Bennett: I should like to add such little weight as I command to the plea of the hon. Member for Stoke-on-Trent, Central (Dr. Stross) on behalf of those who may not intend to practise clinical medicine after they have finished their training. Is the Minister likely to be able to make any categorical statement about whether or not they will have to comply with the internship provision?
The other point I should like to stress was made by my hon. Friend the Member for Putney (Mr. Linstead) about the question of satisfactory service. I should like to invert the way in which he expressed the point and ask whether the Minister, in framing these Clauses, has had in mind any specific ways in which dissatisfaction may be given? What will constitute "unsatisfactory service"? Or is it entirely a matter for the judgment of the employers of the intern in question.
My third point is whether the right hon. Gentleman can yet give us any indication of what will be the length of the term of service of an intern. Is the right hon. Gentleman likely to start the ball rolling with a full year, or will six months or even three months be more likely to represent the period of the first term?

Dr. Morgan: I apologise for being late in coming from hospital this morning. I think there must have been some misunderstanding about the time, because I was told to be here not later than 12.30 p.m. and I kept to that time; but I apologise for not being here to move my Amendments which, had they been taken, would have dealt with many of the points now under discussion.
I wish especially to deal with the question of unsatisfactory service during this year of provisional service. I would ask the Minister to consider if he can, having regard to the source from which it

comes, the question of granting the right of appeal to all medical students who are alleged not to have rendered satisfactory service during the year of provisional registration. As has been said, some of us have had that experience. I had a nice time at my university—Glasgow University, said to be one of the best in the country—but when I came out to get a resident appointment post in a hospital, because the religion of the country was different from my religion and because my politics were extremely different, I could not get a look in.
I remember how enraged was one of my professors to think, after everything I had done, that that should debar me and that I must go elsewhere to get an appointment. I even thought of going to Ireland where, no doubt, in the home of tolerance, I should have been much more cordially received. I would therefore ask the Minister to consider the question of giving to a student debarred during the course of his year for allegedly not having rendered satisfactory service, the right of appeal; with a sworn statement from whoever came to the decision so that the student may have the opportunity of answering the case against him.
A man may render certain "unsatisfactory service" because of his medical theories. I remember in the course of my training as a medical student, the great Professor MacEwen, one of the finest surgeons that Scotland has produced, telling a class quite candidly that when he was being examined in England for his F.R.C.S., and he gave his method of operation for certain things such as the brain and for hernia and things of that kind, he was laughed at. When he was asked, "Whose operation is that?" he said, "Mine" and they told him he was talking nonsense. He replied, "Well, I have done 300 or 400 cases already," and he was laughed at still more. But MacEwen's operation became a recognised operation—not so much in England, but it is still being performed in a modified form in Scotland. His brain surgery stands on record for ever and ever. There was a man with skill, knowledge and inventive ideas who was, so to speak, turned down on the grounds of—in those days—unsatisfactory service. The same thing might happen now during the provisional registration period.
There are not likely to be sufficient hospitals to which these men may go and what will happen then? Suppose this man cannot get into an institution because of the number of students vis-é-vis the number of vacancies? Is he to be kept waiting for his appointment, just as at present many men cannot get into a medical school for studentship? When a man is qualified, he may have great difficulty in finding a hospital recognised for the purpose of giving him his provisional registration. These points may have been covered in previous discussion, and if so I am sorry, but I do want the Minister to keep them in mind, because one of my Amendments sought to give a man the right to appeal to a special tribunal, and it would have covered that point.
A student may have gone to considerable expense to plan not only his studies but his finance without having taken into account this extra period. I know he will get £350, but he may have borrowed the money from his parents, or won a scholarship which does not take him further than three years. I know that I shall be told that certain local authorities will come to his assistance. But so far as I know—it may be changed since the time I got into Parliament and left my local authority experience behind—when giving grants of this description, local authorities have to do so with an eye on the auditor. or they may be reported as having dispensed local authority finance unjustifiably.
I hope the Minister will look at this Clause again and give an opportunity for revision and if necessary Amendment. The important point is the hardship incurred by a man who is declared unsatisfactory or to have given unsatisfactory service, when, before any fair board, he would be recognised as an efficient man, capable of doing his work.

Sir H. Lucas-Tooth: If I may complete the speech which I started to make on an earlier Amendment and adapt what I have said, I would point out that this is of course a machinery Clause with which we are now dealing. Discussion has ranged over the general merits of the case, but it is important that we should have some regard to the actual mechanism.
If we look at subsection (1) we see that the order to be made under that sub-

section is an order which apparently is to relate only to the period during which the intern service is to be performed. In terms, I think, that is the effect of this subsection. But it is also true that the appointed day, under Clause 1 of the Bill, is to be made by, I think, an order of the Privy Council, and will presumably come before the House. I am not sure whether it will be necessary to incorporate it in the order under Clause 2 of the Bill or whether it will be a separate order. But it is important when an order is brought forward to bring this Clause into effect it should contain as much as possible of the machinery which is being brought into operation.
So far as I know, the question of the payment of a provisionally registered doctor during this period will not necessarily come before the House at all. I would ask the right hon. Gentleman whether that is his intention. It seems to me, on the whole, that it would be a good thing if the order did contain general provisions regarding such payment. I am not certain how the payment is to be arranged for. It may be through the ordinary administration of the hospital or it may have to be by some order. It would be interesting if the right hon. Gentleman would tell us, and we should all like to consider the matter before we reach a later stage in the Bill.
There is also the question of the possibility of allowances being paid during this period. I do not know whether allowances would be payable especially, or whether they would be payable by the employing hospital or health centre, or whether they would be dealt with in the order. It would be essential to provide substantial allowances in some cases. For instance, where a rather older man comes in and he has a wife and children, he would have to have something over and above what would be a proper payment to a young man who was simply doing a preliminary period of one year's service. Would that be covered by the Order? If not, how would it be dealt with? I hope that the right hon. Gentleman will answer those questions.

1.0 p.m.

Mr. Iain MacLeod: I am delighted that the Minister has accepted the principal Amendment to this Clause, because a method of medical


administration which may have been appropriate to the Acts of 1858 and 1886 has been inappropriate since 5th July, 1948, when the Minister took a much more intimate responsibility for the health of the people. I should like to emphasise the point made by my hon. Friend the Member for Hendon, South (Sir H. Lucas-Tooth) that, as matters are at the moment—and it may well be a flaw in the drafting of the Amendment we put before the Committee—it appears that Parliament is only to have control of the actual period of intern service. I think that hon. Members on both sides would like to go rather more deeply into the matter than that. When this period starts, there will be a wastage, for one year at least, of general practitioners entering the Service. It is a matter for Parliament to discuss at what point in the development of the National Health Service we can afford that wastage.
The question of universal service has been discussed. Clause 34 gives permission to introduce different dates for different parts of the country, and Northern Ireland was quoted as an example. I suggest that the differences are not all purely in time or in geography. The question of universal service is well worthy of consideration. For example, it might be expedient, for a limited period, to allow doctors who have completed their ordinary training to go into practice in under-doctored areas. It might be expedient to allow them to act as assistants to group practices or, perhaps, in the few health centres which we have and which we hope will increase in number.
The advantage of that method is that we should get more quickly the doctors we need in the places where we need them. The disadvantage, which I need not stress, is that some men might not be as highly qualified and they would, in any case, lack intern service.
It is my view, from such researches as one is able to make without official services being open to one, that there are enough posts available for these men and women. But in this matter we cannot simply equate vacancies with candidates. We may well find that, both temperamentally and medically, we have at the end a number of round holes and only square pegs to fit them, where it would be

unfair for a man to have to take the only vacancy open to him. I think the Minister might consider whether exemptions cannot properly be made.
I appreciate that the Minister may not be able to answer all the questions put to him today, but I think the question of salaries is by far the most important point which we shall discuss during the Committee stage of this Bill. There is some anxiety outside. The Goodenough Committee recommended that free board and lodging and something between £75 and £100 should be paid. If we put that in terms of the value of money today, it might be £150 to £200. Even that is considerably below the amount of money paid to some one holding a house appointment. Nothing would do more to remove the uneasiness than a clear statement about salaries.
There are a number of medical men in this House. There are half a dozen in the Chamber at the moment. It is one thing for organisations who gave evidence before the Goodenough Committee from their established positions, to say that it is desirable for this extra year to be added to a student's training. It is another thing when a man has planned his life, perhaps planned his marriage on graduation and his National Service, so far as he is capable of planning that to fit in with his training, if he finds that there is to be another year of training. Perhaps he may be getting to the end not only of what he thought was his medical training, but also of his own and perhaps his parents' savings as well.
I strongly endorse the suggestion that those at present engaged in medical training should not have this extra year put on to them. I agree that the students' committee before the Goodenough Committee recommended this, but any association or trade union invariably recommends, on Benthamite lines, what they think is for the greatest good of the greatest number. However, there are people undergoing medical training, to whom this is a new conception, who may well be penalised by the imposition of an extra year or indeed more.

Mr. Hastings: As one who has spent the greater part of his life in the training of house surgeons, I should like to say a few words especially about satisfactory service and the right of appeal. There


will be very few cases in which a surgeon or physician in charge will feel justified in saying that a man's service was unsatisfactory, and if the right of appeal were agreed to, there would be even fewer. One must remember that if the right of appeal is granted, the chief would be put into the witness box, presumably, and asked all sorts of questions about his house surgeon and, possibly, even submitted to an action for libel.
Looking back through my medical history, I can remember only one case in which the service of a house surgeon was really unsatisfactory. The surgeon was an individual in a children's hospital, and perhaps the most charitable thing to say would be that she failed to prevent the deaths of four children in a fortnight, and then she was asked to resign. That is the only case in my experience where I could have said that the service was unsatisfactory. In an event such as that, I think that the right step to take would be to let the house surgeon have another try at another hospital. Even if a surgeon has fallen down once, that is not sufficient to prevent his becoming a registered medical practitioner. I hope that this point will be left as vague as possible and that it will be for the medical or surgical chief to say whether the service is satisfactory. I do not think that there will be many unsatisfactory cases.

Mr. Bevan: We have had an extremely useful and necessary discussion. A lot of anxiety has been expressed on a number of points and it is just as well—in fact, not only just as well but highly desirable—that that anxiety should be allayed as far as possible. However. I would point out that, as the hon. Member for Hendon, South (Sir H. Lucas-Tooth) said, this is a machinery Bill. Very largely, it is an enabling Bill. The Minister of Health is not accepting any additional academic responsibilities. He is accepting none at all, because it has been not only the theory but the practice of our constitution that the Government does not intervene either in the organisation or the content of the curricula of our educational establishments. They are under the great educational corporations and the universities.
Therefore, I would at the very outset try to get rid of the idea if there be any misapprehension about it—that the

Minister of Health is here accepting responsibility for the content and management of medical education, because he is not. This is being still entrusted, some part to the Privy Council and some part to the medical corporations, all of them acting jointly, and especially where we come to inspection in the later parts of the Bill. I thought it necessary to make that quite clear at the very outset, because I see that the Minister of Health, as usual, has been selected for certain remarks which have now become almost habitual—I do not mean from the salubrious seaside resort from which the hon. Member for Luton (Dr. Hill) has come—but by some who have written to the newspapers.
Let me say at once that it is necessary for us to have a sense of proportion and keep an even balance between the legitimate affairs of the medical students and the requirements of the public. We are, in this House of Commons today, the trustees of the general public, and we must always have regard to the fact that it is not our duty to let loose upon the community what might be regarded as under-educated doctors, nor to protect individual doctors from what might appear to be hardship. It is always the case that the corporate body has a voice in the House of Commons, but the only way in which the general public can have a voice is by our zeal on their behalf, and we must always keep that before us.
On the other hand, it is perfectly true, that the implementing of the Goodenough proposals does mean that the State intervenes and alters the plans which the private citizen makes for himself when he intends to go in for medical training. Therefore, what we must do is to try to mitigate the hardship as much as possible and see to it that the arrangements made bear as little harshly upon the citizen as is consistent with the public interest.
In the first place, this is not going to be sprung upon the student immediately. It is going to take between a year and two years to make these arrangements, because, of course—and this answers one of the questions put to me—it will be quite improper for the State to say that a doctor cannot be fully registered and enter into general practice unless he has an intern year in an approved establishment which has failed to find a place for him. Both must go together. It must be made quite clear that it would be


intolerable if we said to him "You have not qualified, but we do not propose to give you the opportunity of doing so." It must be quite clear that we cannot fix the period when it starts to operate until we have reviewed the establishments and made the posts available. I hope this will also assimilate part of the trouble that was raised by the hon. and gallant Member for Chelsea (Commander Noble) about ex-Service men. I should have thought that, by the effluxion of another year or two, most ex-Service men would have passed from the schools, and that there would not be very much hardship there.
In the next place, not only have we to provide the posts in hospitals, but it is quite clear that, at the same time, we must also be able to see to it that the hardship is mitigated as much as possible on the financial side. It is. therefore, proposed, to create posts carrying £350 a year for the first six months and £400 a year for the second six months, with a deduction of £100 for board and lodging. I think the Committee will agree that these are fairly generous sums to be paid, and, indeed, many general practitioners will say that it is more money than they earn in their first year of general practice before the war, at any rate. I think, therefore, that we complain that, so far as we can. we have gone some distance to meet the hardship that would fall upon the student. I hope that, after that, I shall not be pressed to make exceptions.

1.15 p.m.

Sir H. Lucas-Tooth: Before the right hon. Gentleman leaves the financial part, will he say whether there will be any arrangements for allowances in the case of those who are married?

Mr. Bevan: I am afraid not; at least, it is not our present intention. After all, some of the students will be married already, and its does not necessarily follow that we are imposing a hardship. We are giving £350 and £400 a year, and, at any rate, I dare say that, as this is a machinery Bill, these conditions, therefore, are not conditions which I impose. At the moment, I am merely telling the House what the general intention is. We shall have a look at the point, however, and see whether anything further can be done in that regard.

Dr. Hill: Will this be technically applied at the beginning of a provisional post, for entry into the National Health Service Scheme? It is the superannuation implication which I have in mind.

Mr. Bevan: That is a very special point, but I should have thought it would be understood that these sums must be carried on the Ministry of Health Vote and not on the University Vote or the Education Vote. Therefore, those doctors who are provisionally registered, will be employees of the hospital, and I should have thought that it follows almost inevitably from that that the term of service in the National Health Service would date from the beginning of the internship. But I hope the hon. Gentleman will not keep me strictly to that. I should have thought that it would be a logical inference, and it may be that the logical inferences of the Minister of Health may be regarded, by some pepole, as an indication of what might happen.
The internship period is also necessary because, for the purposes of his post as a fully qualified doctor, he has not yet gone into general practice, but, of course, for all the purposes connected with his work in the hospital and in connection with any work which might be given to him arising out of his internship, he is a doctor, and hon. Members will see in different parts of the Bill how that is provided for. Of course, some people have asked if it is fair to a person who has made his plans, based upon the assumption that his training is going to come to an end, that we have added another year, but we have got to start sometime, somewhere. If we are to carry out the recommendations of the Goodenough Committee, we must begin at some point or another.
The suggestion is that we should begin with the student coming in, and that means that our scheme will not come into full operation for seven or eight years. Surely, that is going far too far, because he is a person who will have made his initial plans, and who knows that he is going to study to be a doctor, in the light of what he considers to be the number of years which he will have in which to qualify. We are adding a year to that. But I should not have thought that he would want to go back as far as that. I hope I shall not be pressed to give concessions on grounds of hardship. Why


should this House send out into the world of general practice one who is less well-trained than we think he ought to be? That, surely, is to the detriment of the patient, and is not good for the doctor. When the date falls, it should fall upon all the medical students, as, otherwise, one medical student will go through his life with a black mark. It will be said, "Oh, you did not have the year's intern, but your colleague had it." Therefore, I should not think it would be wise to invite the medical student, because of some temporary embarrassment to handicap himself by not having the benefit of the one year, and I hope we shall not be pressed in that respect.
There is a good deal of anxiety about this business of satisfactory service. Of course, it is almost a subjective term, and because it is subjective, it is the very one that causes most fear. All of us can understand it, because it is so difficult to define. Nevertheless, it is already in use. I have asked for information about this, and I am informed that it is similar to the signing of certificates now required to show a satisfactory attendance at courses of instruction before a student can sit for his final examinations.
These certificates cover conduct as well as attendance. They represent the opinions of all the people under whom the student has worked. Similarly, certificates of satisfaction will reflect a number of opinions, and there should be no possibility of victimisation by a single individual on personal grounds. The certificate itself is given by the licensing body, that is, by the medical corporation immediately concerned. Therefore, there can be no possibility—indeed, it would be frightening if there were—of a superintendent of a hospital, who might have developed a "grouch" against an intern, reporting upon him unsatisfactorily, because he would, surely, have the collective opinions of all those with whom the provisional doctor had worked in the whole of the year.
I hope, therefore, that we shall not be pressed to give a right of appeal. With whom could an appeal lodge? We cannot have an appeal against a board of examiners—I do not think the animal exists in the whole academic body. The examination takes place, and, I should have thought, takes place as objectively as possible, and sometimes, as we all

know, as impersonally as possible, so that the name of the examinee does not appear. I should not have thought, therefore, it was possible to think of a body to whom an appeal could be made which would not detract from the authority of the examining body itself.

Sir H. Lucas-Tooth: Will there be an examination in this case?

Mr. Bevan: No, it is a report. As we all know, under the normal school system, the certificate is not validated until a year's satisfactory service is given in the schools, and the inspector reports upon the teacher. If that happens with regard to a school teacher, how very much more important it is in the case of a person to whom we are entrusting the welfare and the lives of the whole population. Therefore, I hope that we shall not be pressed on this matter of appeal.
I hope I have said enough to reassure the student that he is not putting himself in the hands of some individual who might have a spite against him. We must remember that when a person reaches this stage, he is provisionally registered. The intention is not to put up another hoop through which he has to jump; the intention is to give him a year's experience in association with specialists and with a diverse kind of hospital work, so that when he goes out into the world as a general practitioner he will be a better craftsman. It is not intended to put another obstacle in his way; it is intended to be, as it were, the consummation of his general medical training. Further, if an appeal can be made against the report on the student, would there not be a disposition to say, "Oh, well, he can appeal."? There may be a tendency to increase the number of adverse reports if it be present in the mind of the person sending in a report that, after all, an appeal can be made. I should have thought that, having regard to all these matters, the Committee might perhaps permit us to go on with the Committee stage.

Mr. I. J. Pitman: Would the right hon. Gentleman answer one question for me on this? Is it possible for the intern who gets an unsatisfactory report, to seek another post at which he can have a second year?

Mr. Bevan: Certainly; there is no reason at all why if he has "blobbed it," he should not have another opportunity. Anything can happen to a young man or woman at that time. They may have got themselves into a very unsatisfactory set of domestic circumstances or bad companionship. Any kind of thing can happen. Anything can happen to all of us; it sometimes happens in Committees that we get at odds with the world. Therefore, if a person has had a bad time, he ought to be given another chance in another hospital so that he can serve another year.
There is one thing about which I have been rather worried since we made the Amendment, and that is its coming into operation at different times at different places. For the life of me, I cannot see how it is to operate, and also I do not see how it is going to operate with reference to reciprocity with Eire. I think the present intention is to bring this into operation everywhere at once. I just do not see how it is possible for us not to have all kinds of discriminatory, charges, when a doctor goes straight into general practice in one part of the country and another doctor, in another part of the country, is kept back a year. Having regard to all the administrative perplexities, we come down on the side of applying it universally. The power to vary the period is merely for the purpose of emergency.

Lieut.-Colonel Elliot: I think that the Minister has performed a very useful function today in giving us a forecast of what he has in view. I trust he will be able to answer the point pressed by one of my hon. Friends, and which, I gather, he did not answer, namely that the affirmative procedure would not be so narrowly drawn as merely to cover the time, but that the regulations which were being submitted to the House for affirmative Resolution would take into consideration some of the points which he has been laying before us this afternoon.

Mr. Bevan: I am very glad I was asked that question. The answer is, as the right hon. and gallant Gentleman knows, that if we put too much of what might be regarded as rules into the orders, they cannot be varied without another order. Therefore, to some extent, it would

handicap the administration, which would need to be as flexible as possible. For example. if we put the terms of remuneration in the order, we could not alter them without coming to Parliament. Therefore, any negotiations that took place could always be subject to legislative approval. I doubt very much whether we want to put too much of that detail in the order, but what we will have to put in the order will be the intern period, and things connected with that.

1.30 p.m.

Mr. Linstead: There is a point on this which the Minister may not be able to answer now, but I should be grateful if he will look into it. In Clause 2 (1) there is a reference to regulations of the Council approved by order of the Privy Council. That brings Parliament into the picture, but in Clause 2 (2) in line 7 there are regulations of the Council without any conditions of approval by order of the Privy Council. Similarly, in line 17 there are regulations of the Council again not to be approved by the Privy Council. Therefore, it looks at first sight, at any rate, that in the case of those two regulations Parliament is left out of the picture. Is that right and, if so, is there any reason for it?

Mr. Bevan: Yes. Parliament is left out of the picture quite frequently when rules are made. When regulations are made—they are not rules usually—they can be prayed against. Where they are rules, Parliament is not brought into the picture, except by raising the matter with the Minister either on Supply, or in another way, because, as hon. Members will appreciate, it would be very difficult if Parliament tried to concern itself with such minutiae as that.

Mr. Linstead: But these are all concerned with periods of time and nothing more.

Mr. Bevan: Is it the intern time that the hon. Member has in mind?

Mr. Linstead: Intern time must be approved by order of the Privy Council, but the other two periods, which are only periods of time and nothing else, are left entirely to the discretion of the Council.

Surgeon Lieut.-Commander Bennett: May I ask if the Minister would have in mind in this connection the question of


the exemption of the "deviationists" who go into biochemistry and other things?

Mr. Bevan: We could not possibly do that. If a man said he had qualified and wanted to be exempted from the intern year, because he did not want to practise clinically, he would be a very queer kind of medical animal. We should not know what to do with him afterwards.

Surgeon Lieut.-Commander Bennett: The universities are full of them.

Mr. Bevan: That may be so but, as far as I know, nothing at present stops their practising clinically if they want to do so. There is no law—

Dr. Morgan: There is no law against anybody practising, qualified or unqualified.

Mr. Bevan: Yes we know. What we mean is that they are on the Medical Register, and therefore can practise clinically. Would those persons say they would not want to be put on the Medical Register? I think it would be found that we could not frame an Act which would put them in suspense, as it were. They are so difficult to define. They would be like Mahomet's coffin. They must come down on one side or the other, otherwise we might have some who do and some who do not intend to go into clinical work, or some who do not but who might.

Lieut.-Colonel Elliot: I will, if I may depart from consideration of Mahomet's coffin. You may not know, Major Milner, that I did catch your predecessor's eye, and what was going on just now was a series of sub-committee meetings of the Committee. The particular point I was raising with the Minister was whether the regulations should only cover the time or go a little wider. I agree with him that one does not wish to be too meticulous, because the old maxim that to include one thing is to exclude another holds terribly true in these things. If the Bill permitted discussion of these regulations to range wider, it would be to the advantage of all of us.
Obviously, before such regulations were drawn, they would be the subject of close consultations with my hon. Friend the Member for Luton (Dr. Hill), in some of his other incarnations, or

possibly with his successor. But I think it would be desirable that here in public we should have the opportunity of reviewing the matter. The Minister knows, as well as I do, that when an affirmative Resolution covering something is submitted, it may be a narrow Parliamentary opportunity. The things we have to review are not narrow. I am sure it would be to the advantage of the Minister, and certainly to the advantage of the House and the country, that discussion should further enlighten all those concerned, as discussion this afternoon is further enlightening all of us who are taking part in it.
I do not wish that these things should be written into regulations, but that the regulations should be so drawn that they do not limit Parliamentary discussion so closely that it would be impossible to raise these matters on the Floor of the House. I should be glad if the Minister could keep that in mind. Obviously, this will not arise immediately, because, as he says, it will be a year or two before such regulations have to be laid before the House. If words like "and connected therewith" could be introduced to enable these difficult points to be raised, it would be to the advantage of all of us concerned.
I am sure the Committee is working at its very best today. It has a piece of ironwork on the anvil before it, and is actually hammering it out here. Several points have been raised on which I think we, on this side of the House, are agreed with the arguments the Minister advanced. There is, for instance, the point about appeal. I do not see how an appeal from an examiner can lie. I think the Minister went far to meet that point when he said it would "encloak," so to speak, the views of a number of persons, and would be similar to the certificate of satisfactory service which an inspector gives in the case of a school. I think an appeal to an outside body, which could not possibly have the same opportunities of examining or considering the work of the person as those who have originally been in the position of giving the certificate, would put the unfortunate man almost in the position of doing another term of service under the supervision of an examining body. It might lead to confusion worse confounded.
It is for the reason that these will be discussed closely between representatives of the student body, the professional bodies, and the Department that freer discussion on these points, when these regulations come up for affirmative Resolution, will be of very great advantage to all concerned. Again, I think the Minister was probably right when he said that the scheme will have to come into operation everywhere at the same time. A provincial qualification or relaxation would be a most difficult thing to operate. I believe that in the University of Bologna a student who did not entirely satisfy his examiner was given a certificate marked. "Bon pour l'Orient" or "All right for the East." And "Exempted from intern service because no post available" would be an awkward endorsement to have on a certificate for any of us.
The Minister is probably right on the point made, on this side, that those not desiring to go on with this, or those desiring to go in for something like special service of one kind or another, should be exempt. The simple line on that is not to have one's name entered on the Medical Register. I do not think that it is possible to say that a man who may afterwards change his plans and not desire to go on with his particular special qualification should be entered as a fully-qualified man, when in fact his qualification was less than that of one who had studied alongside him. I think that if on a subsequent occasion he wished to enter into general practice, it would not be possible for him to do that houseman training. I think that it would be very necessary indeed, if he was going to enter into general practice, that he should have some kind of refresher course, because a long period in research severs one very much from the rough-and-tumble of the actual practice of medicine.
I remember Lord Boyd Orr telling me of his mental distress when, having spent his early years after qualification in high research, he found when he entered the Army that on account of his singular qualifications he was immediately put in charge of wards containing a number of acutely ill people, and told he must be properly able to look after them. This caused him mental anguish and distress, and a great deal of hard work while he was polishing up his rather rusty medical knowledge.

Dr. Morgan: The right hon. and gallant Gentleman is talking of men who are going into research. Let us take the man who wants to go into tropical medicine. Why should that man, in view of the limited number of hospitals here, have to go into hospital and serve his term of probationary service when he wants to get into tropical institutions here. If he can get into them, let him do so, but if he cannot, then let him go straight to the tropics.

Lieut.-Colonel Elliot: Surely, anyone going out to places far removed from the medical schools to take up tropical medicine, ought to have an acquaintance with general medicine, because he will have this work thrust upon him at short notice by people who trust very deeply to a medical qualification, and who may feel justly aggrieved if they find that he has escaped some particular course of training, which another man beside him may have taken.

Dr. Morgan: I think that the right hon. and gallant Gentleman is doing an injustice to the medical schools if he thinks that a man after five years of study—despite the year he has not spent in a resident medical capacity in a hospital—has no knowledge of medicine at all. That man up to the present will have done excellent service and will have excellent knowledge.

Lieut.-Colonel Elliot: It is straining it to say "no knowledge of medicine at all." It is a recommendation of the Committee that this extra refinement of medical education should be universally applied, and, if it were, I cannot conceive any person to whom it would be more rightly applied than to the man going abroad, who is severing himself from immediate contact with the great apparatus of healing available at short notice in this country. That is a difference of opinion. I only say that, on this, I myself would share the view which the Minister has put forward.
The suggestion as to remuneration has been worked out fairly closely by hon. Members on this side, and the remuneration in terms of cash now would be about £150. The sum suggested is about £200 with a reduction of £150 for board and lodging. I hope that the Minister will keep his mind open as to the possibility of a supplementary allowance of one kind


or another. There are a number of people of considerable seniority who are now graduating and who have wives and families. A man with a wife, and possibly with a family, who is not able to get accommodation in married quarters, would find the sum of £200 small enough, to maintain his household in separate quarters. The Minister intimated that he would keep that in mind, and I trust that he will. All these are matters which will he threshed out in the year or two that lie immediately ahead of us. I think that this is as far as we can usefully carry the discussion on this particular point this forenoon.
Another opportunity will certainly arise, and for that we are grateful to the Minister for accepting our Amendment that when the affirmative resolutions come up to be debated and the actual enabling Bill has enabled the machinery to be set in motion, and the actual proposals affecting the individual lives of the graduates are before us for consideration, we shall have an opportunity to review these matters. I am sure that a useful purpose has been served by the discussion this morning. and that many of the doubts and fears put up to us by the Students' Association and others have been dispelled today.

Question put, and agreed to.

Clause, as amended, ordered to stand part of the Bill.

Clause 3.—(SPECIAL PROVISIONS AS TO EMPLOYMENT IN HEALTH CENTRES.)

1.45 p.m.

Mr. Hastings: I beg to move, in page 3. line 14, to leave out paragraph (b).
I hope that I may be permitted very briefly to put my case before the Minister, and that he will unequivocally accept my Amendment, as I have no doubt he will, when he has heard the arguments. I agree entirely that there can be no better training for a general practitioner than to take part in the general work of a health centre, to undertake substitution duty for all those working there, and to be specially attached to perhaps one or two of the senior members. In my view no better training can be imagined for general practice.
But when we come to the special departments which, we hope, will be working in the health centres, and where on

one or two days a week, the skin man, or the nose and throat man, or the eye man from the hospital comes to the health centre to see, not just ordinary cases but cases sent on by the general staff of the health centre, about which their combined wisdom cannot find an efficient answer, and the needs of the services of a specialist are required—in such cases, I regard the work in the specialised departments as first-class training for young specialists but not for the provisionally registered doctor who is wanting to obtain a complete registration. Therefore, I hope that the Minister will agree with me in proposing the deletion of paragraph (b).

Mr. Bevan: It will be within the knowledge, I am sure, of hon. Members that the provision relating to health centres was put into the Bill in another place. I accepted it, but I am bound to say I did so with considerable misgivings. I thought that it would have the consequence of detracting from the value of the Bill itself unless it was handled with extreme care.
First of all, it is the hope—although I think that we must keep some sense of proportion about it—that subsequently most general practitioners will be engaged in group practice, and will be operating from a building which might be described as a health centre; but everyone knows that health centres can be variously defined. We can have a very big polyclinic centre, in which there is a considerable variety of diagnostic facilities alongside maternity and child welfare centres, local authority dental and ophthalmic services, and the whole range of personal medical services outside the hospitals. It might be possible to find a health centre of that sort as a place where the year intern service could be served, but we have none of them at the moment, as far as I know, and it will be a very long time indeed before the country is going to have them, if ever it does have them.
These are institutions which ought to be examined further before we embark upon them, because unless we are careful they will be merely reproductions of the hospital itself, apart from the fact that they will not have patients staying in them. I am extremely doubtful about this proposal, and I hope that when these institutions come to he approved it will


be done with extreme frugality. I should have thought that one of the main purposes was to bring the would-be general practitioner into daily contact with the specialist services. The effect of the Amendment will be to deny to the intern physical access to the work of the specialists if he happens to be in an outpatients department of a health centre. That would surely be a distortion of the whole thing, and would merely mean prescribing an assistantship only for the internee year.

Mr. Hastings: May I point out that the Clause does not say "employment in the general service and employment in such out-patient services," but either employment in the general service or in such out-patient services? I take it, therefore, that the meaning of paragraph (b) is that employment in the special out-patient services takes place only in a health centre, and will qualify as an intern period.

Mr. Bevan: If we had to choose between the two, I would select paragraph (b) as against paragraph (a), because in the case of paragraph (b) the intern would be in daily association with the specialists, whereas in the case of paragraph (a) he would be in daily association with general practitioners. If it be the fact that ultimately we want all doctors to work in group practices from health centres, we shall be prescribing that the intern year shall normally be service with general practitioners. We do not want the interns to serve in health centres, but to have a full variety of experience of all the services.

Dr. Hill: I think that the Minister's arguments are unanswerable. It is desirable, most of all, that this intern period shall be spent in a hospital, and that it shall not be merely a year attached to the end of a man's training. I agree that if there is to be a second-best and a third-best, this opportunity for specialist work in the out-patient department, particularly in the field the hon. Member for Barking (Mr. Hastings) suggests, is the second-best. I wish to underline what the Minister has said—that these alternatives are less desirable than the hospital. I hope that we shall not get into

the habit of regarding this as a year added to the ordinary medical education, but rather as a phase of responsible work. I suggest that paragraph (b) is important, but that both are less important than the main theme.

Dr. Morgan: I so seldom agree with the Minister on this Bill, that I should like to say that on this occasion, like the hon. Member for Luton (Dr. Hill), I think his answer is unanswerable. In an institution an intern may get every practical phase of medical diagnostic skill portrayed to him. He may even get mental cases, but at a health centre he is very unlikely to have any experience of such cases, even if a psychiatrist were at the health centre. I hope that when a man wants to specialise he will go into a mental institution after his period of service is over, and that he will not spend this extra year in a mental institution. If he wants to specialise, he should go to an institution after his training.

Mr. Hastings: In view of the fact that the danger which I so seriously apprehend is not likely to come about until there are more health centres, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause ordered to stand part of the Bill.

Clause 4 ordered to stand part of the Bill.

Clause 5.—(PROVISIONAL REGISTRATION.)

Mr. Bevan: I beg to move, in page 4, line 20, to leave out from "registered)," to "registered," in line 22, and to insert
for the words 'under this Act' there shall be substituted the words under the Medical Acts or provisionally so.'
Perhaps the Committee will permit me to explain the purpose of this Amendment and the following few Amendments standing on the Order Paper. They are not as formidable as they look, nor are they the result of second thoughts about the Bill. On the contrary, they are the result of the fact that, after the Bill emerged amended from another place, the Parliamentary draftsmen sought to take this opportunity of anticipating consolidation, and therefore to alter the nomenclature so that the work will be simplified when consolidation takes place.

Amendment agreed to.

Further Amendments made: In page 4, line 25, leave out "medical register," and insert:
registers to be kept under the Medical Acts.

In line 26, leave out "a separate part of that register," and insert:
separate parts of those registers.

In line 28, leave out "that," and insert "the separate."

In line 35, leave out from "Council," to "and," in line 36, and insert:
a register relating only to persons provisionally registered, to be called 'The Register of Provisional Medical Registrations,' in the like form and containing the like particulars as the Medical Register, but compiled by reference to such date or dates in the year as the Council may direct.

Leave out lines 38 and 39, and insert:
Register of Provisional Medical Registrations as, it applies to the Medical Register.

In line 46, at end, add:
and the register in which provisional registration is to he effected shall be determined accordingly."—[Mr. Bevan.]

Mr. Hastings: I beg to move, in page 4, line 46, at the end, to add:
(8) A person provisionally registered under this Act shall have all the duties and privileges of a registered medical practitioner but only while serving in an approved hospital or institution as defined in Section one.
What medical students are everywhere asking is what will be their powers and duties when they are provisionally registered. The Committee ought to know what it will be possible for a provisionally registered doctor to do. I do not think we are justified in leaving this matter entirely to a question of regulations. I suggest that a provisionally registered doctor will have the powers of a fully registered doctor only when serving as an intern in the institution to which he is attached. In other words, if he goes away for a weekend as a locum he will not be able to sign death certificates and order poisonous and dangerous drugs. What I feel very strongly is that while this man is serving in hospital he should have the full powers and duties of a medical practitioner.
2.0 p.m.
Might I make two points? First, there is the question of ordering dangerous drugs. I do not think a man can do his duty in an intern hospital without that power. He may get a case coming in suddenly of a bad accident or an individual with coronary thrombosis in the

most acute pain which anyone can suffer, and he ought to be able to give morphia in such cases without waiting to send to his chief for permission.
There is then the question of the signing of death certificates. I feel that that should be permitted to him, too. A case could happen concerning an individual attending the outpatient department with some kind of heart affliction. The person comes into the hospital, but before the chief can be called he dies. The provisionally registered doctor knows about the case; there is a full record, but the only person who has seen him is this provisionally registered doctor. I feel that in such cases he should have the right to sign the death certificate. I feel, too, that everybody, including the public, should know exactly what are the powers of the provisionally registered doctor, and that these should not be left to be defined by regulations.

Dr. Morgan: I agree with all that has been said, and I think it rather hard lines if a man, after his medical training and after getting his certificate, decides not to accept these terms, because he will have to get into another profession. The only difference between my hon. Friend the Member for Barking (Mr. Hastings) and myself is on his point that this must apply only to the institution to which the provisionally registered man has been attached. Under the National Health Service, some of these men may be appointed under a regional board which has several hospitals under its jurisdiction. The man may serve for a time in one institution and then the board may want to change him to another institution, in which event he comes under the ban mentioned by my hon. Friend, and cannot continue in his job.
Some laxity should be allowed, and I think the Clause should stand as it is. Of course, I should like my Amendment to be made, but I am prepared to let that go. The Amendment now under discussion will, in my opinion, do the Service harm and the man an injustice, if he has to stick to a particular hospital to which he is attached after being provisionally registered. I, therefore, hope that my hon. Friend will not succeed in his Amendment.

Mr. Pitman: There is a point to be cleared up here, and I do not know


whether the Minister can consider it between now and the Report stage. It is that the public and other doctors should know clearly whether people who call themselves doctors, are in fact qualified to treat and to give orders in respect of, say, a street accident. I had the misfortune to break my leg on the football field, and people immediately jumped in to assist. It may well be that Dr. Fleming, of penicillin fame, might be the head of a medical faculty and not be qualified to do anything outside his particular hospital. There might be other doctors who would come up later. They see Dr. Fleming in charge, giving orders to the Saint John's Ambulance people and others.
There is no clarity of power and responsibility as between the various people in such an emergency. The word "Doctor" is loosely enough used as it is, and I think there is in this very great danger for legal actions to be based on a doctor following what he believes to be the orders of a fully qualified practitioner, who turns out subsequently to be one of those curious, non-professional men, who are neither fish, flesh, nor fowl, who has not done his year but has gone into university research and is not, therefore, properly qualified to give orders either to doctors or nurses.

Surgeon Lieut.-Commander Bennett: I should like to join issue on one point with the hon. Member for Warrington (Dr. Morgan). He suggests that if an intern doctor is permitted to carry out full medical functions at one hospital, on transfer to a hospital where he becomes an employee of a regional hospital board he loses that power. It is only consultants and senior hospital medical officers who are employed by the regional boards, and all the junior ranks are taken on by the hospital at which they work.

Dr. Hill: I am rather uneasy about this. If it is agreed that the practitioner on becoming provisionally registered should be regarded as a registered medical practitioner for a fairly wide range of purposes, then this year may fall into disrespect. I believe it must be regarded as an essential part of medical education, and at the risk of repetition, I say that to equate the provisionally registered with the permanently registered

man, merely leaving an interval of time to pass between them, seems to suggest that the standard of registration is reached with provisional registration, and that this final year is a kind of burden or testing time imposed by the State.
We must get it into our minds that this year is part of the medical education, and we ought not to determine, without very careful consideration, those purposes and functions that are reserved to registered medical practitioners, to pass them automatically to the provisionally registered man, even though he is in a hospital. I confess I prefer the words here, because the Clause that follows possibly needs a certain amount of further consideration. Indeed, until we see the picture of this provisional year, and until we see the form that the internship takes, I doubt whether we are in a position firmly to decide that all the privileges of registration should go with provisional registration. It needs more thought and more consideration before such a decision can be reached.

Mr. Bevan: I am in fairly general agreement with what the hon. Member for Luton (Dr. Hill) has just said. Unless we are exceedingly careful, this intern year will lose its status. After all I know it is difficult to describe it except that it exists in other academic fields. It is not that the doctor is not fully educated when put on the provisional register, but it is considered that a year's satisfactory experience of this sort is necessary for his final equipment as a general practitioner. That is the kind of reasoning that lies behind the Goodenough recommendation. I explained earlier that for purposes of his intern year he is a fully qualified doctor. In the institution he can sign death certificates if it is appropriate for him to do so in the circumstances of the case, and he can give drugs. He can do all those things which are appropriate to his position as a doctor on the staff of that hospital, which indeed he is, and he is paid by the hospital. Therefore, his status in the hospital is fully protected.
Also, the status of the intern year is protected by confining his powers to his internship and saying that outside, he cannot act as a fully qualified practitioner. In other words, it means that he has not got on to the Medical Register


but only on to the provisional register. The difference is that until he has served this further year he cannot get on to this further register. Here it is stated positively, as in most Acts of Parliament, not negatively. What is not stated here, he is assumed not to possess. Subsection (3) says:
Persons provisionally registered shall be deemed to be registered so far as is neces-sary—
(a) to enable them to be employed as mentioned in subsection (1) of section two of this Act,
Where it is not stated, they are assumed not to be, because registration and qualification are qualifications and not negative rejections. Therefore, I prefer the words here.

Dr. Morgan: Would the Minister make it clear whether it is a single institution?

Mr. Bevan: An institution for purposes of the statute is not a building, and therefore an institution for this purpose could comprise several hospitals or any of those hospitals that are approved for this purpose.

Sir H. Lucas-Tooth: Is the right hon. Gentleman completely satisfied that the rights and interests of third parties vis à vis these hybrid individuals are safe? They may find that a person provisionally registered purports properly to act as a doctor in one case and is unable to do so in another case. That may be difficult as far as third parties are concerned.

Mr. Bevan: I am not a lawyer and I cannot say how far third parties are affected by this, but there is nothing to prevent any citizen from coming to the medical assistance of any other citizen. He can do that, but he cannot claim that for those purposes he is a fully qualified registered medical practitioner. Therefore, in so far as that would affect the rights of a citizen whom he attends, that risk would be carried. I should doubt, however, whether any legal burdens would follow because if someone in the absence of anybody else gave any skill at his disposal to an afflicted person, he would be an extremely unChristian person who would then proceed against that man because he had made a mistake.

Mr. Pitman: I see the Minister's point but there is nevertheless a point of third

party relationship. There may be several doctors who leap to the case, one of whom appears to be the senior and he may get on the scene first. It may well be that the relationships between third parties would be befuddled by this lack of extension of the powers of the provisionally registered man to emergency cases of this kind, and it may well be worth looking into.

Mr. Bevan: I will certainly look into it, but I cannot see, for the life of me, how we could protect ourselves against it.

Mr. Hastings: If I heard the Minister aright, he agreed with me completely on the substance of my Amendment. Would he consider putting this in the Bill or, at any rate in the regulations which will be framed eventually? If the Minister agrees to do that, I should like to withdraw my Amendment.

Mr. Bevan: I understand on my reading of it that it is in the Bill now.

Mr. Hastings: Then I beg to ask leave to withdraw the Amendment.

Amendment, by leave withdrawn.

Motion made, and Question proposed, "That the Clause, as amended, stand part of the Bill."

2.15 p.m.

Dr. Hill: I have referred to Clause 2, and a little earlier the question was raised of the practitioner who, after passing his examinations, wished to go into laboratory work, into research, tropical medicine and the like. The substance of the Minister's answer—I believe I am right in attributing it to the right hon. Gentleman—was that the man might become provisionally registered and enter his field of work without becoming permanently registered, and if subsequently he decided to practise clinical medicine, it would be necessary for him to do his intern year. With that contention I agree, but, as the Clause is worded, on passing his examinations the individual will be required to apply for and obtain a post. The relevant words are:
Provided that he produces evidence satisfactory to the registrar that he has been selected for such employment as is mentioned in subsection (1) of section two of this Act,
It seems to me to be a difficulty that passing the examinations and obtaining the diploma, in the university sense, of itself does not entitle a man to provisional


registration. Even though he is going straight into laboratory work, he has to apply for and obtain a post. This is worth reconsideration so as to make possible the idea expressed earlier. As matters stand, passing the examinations, of itself entitles the person to nothing, not even provisional registration. He has subsequently to apply for and get a job.

Dr. Morgan: There is a point arising on my Amendment. A man may apply for a post in order to get permanent registration and may not succeed, but equally he may not apply. What is to be done with a man who has all his degrees and does not apply to be put on the provisional register? Is that man to be wasted in a period when there is a shortage of medical practitioners? Would the Minister explain that?

Mr. Bevan: As I understand it, the argument is this: the person has passed his examinations and at that stage he asks himself what his future course will be. He may decide not to go in for clinical practice but for research work. Therefore he does not want to serve his intern because the intern year is for the purpose of getting him on the medical register which is not essential for the specialised work he proposes to do. Therefore he wants to be exempted from the necessity of serving the intern. At some later stage, however, he may want to become fully qualified, so he ought to be allowed to apply to be put on the provisional register at any time.
I think there is some substance in that argument. Of course there is no reason why he should apply for the provisional register. I see that the man's future rights need some protection, because—I am thinking aloud for a moment—he ought to be able to complete his training at some future period if he so wished. I will look into the matter to see whether this would be covered.

Sir H. Lucas-Tooth: In particular there is the case of the man who is qualified by examination in this country and who may wish to do his intern service overseas.

Mr. Bevan: In that case, it is not so difficult.

Sir H. Lucas-Tooth: But it would be extremely useful to the man if he were

able to produce evidence of provisional registration instead of showing merely that he had passed the examination.

Mr. Bevan: Yes. It is not always easy, when looking at these very technical Bills, to see what construction they bear. As I understand it, there is nothing to prevent a man from postponing his application to be put on the provisional register almost indefinitely, so that his rights are kept alive. I will, however, see whether it bears that interpretation.

Dr. Hill: Would the Minister, in reconsidering the matter, give a thought to the suggestion that provisional registration should be obtainable on a man's satisfying his examination for his diploma? After all, it is provisional registration and nothing more. Thereafter, the man has to apply for and to get his appointment and to hold it for the specified period before full registration is granted.

Mr. Bevan: I see some difficulty here. The educational authorities must have some assurances that the posts they are making available are going to be used, because the assumption is that when a man applies to be put on the provisional register, he wishes to have a post to complete his intern year. Nevertheless, I see no great administrative problem here. The man could indicate whether he proposes to take up the post at once, so as to give the authorities the necessary information. In any event, I will see whether this position can be cleared up.

Dr. Morgan: I want to make a point about homoeopaths. There may not be sufficient posts in institutions to enable them to serve their year of provisional registration. Sometimes the waiting lists would involve a wait, not merely of one year, but perhaps of two or three years, before a man could enter a homoeopathic institution in order to qualify under the Bill.

Mr. Bevan: Now we are treading on dangerous ground and I move gingerly as though I were treading on the fields of asphodel. When we come to consider homoeopathy and more orthodox medical practices, this is where a layman refuses to express any opinion at all if he has any sense—and I have quite a bit of sense in this field in the last five years at


least. I should have thought that homoeopathic medicine is not necessarily excluded by learning all medicine. Thinking aloud once again, I see no reason at all why the intern year could not be served in a general hospital, and homoeopathic practice is merely a matter for the individual doctor to decide to do as a doctor when he has qualified. Over that, we have not the slightest control.

Dr. Morgan: I was speaking of the qualified doctor who had taken all his medical examinations.

Mr. Bevan: No. We have just said that a person is not qualified for general practice until he has served an intern year. What I am now asked to do is to make sure that arrangements are going to be made for him to serve that intern year in a homoeopathic hospital. I am afraid that I cannot give such a guarantee at this moment. As has been said, there might not be enough posts.

Surgeon Lieut.-Commander Bennett: The problem which was raised by my hon. Friend the Member for Luton (Dr. Hill) might not appear so awkward if it were made clear that university and research authorities, when seeking people holding medical degrees to go on to their staffs, asked for people holding degrees or diplomas rather than for people who were on the provisional register. If it is only the possession of a degree that is necessary for research, then I think that the question of a provisional register would not arise.

Question put and agreed to.

Clause, as amended, ordered to stand part of the Bill.

Clause 6.—(SPECIAL PROVISIONS AS TO HOLDERS OF DIPLOMAS GRANTED IN REPUBLIC OF IRELAND.)

Mr. Bevan: I beg to move, in page 5, line 19, at the end, to insert:
() In relation to any such person as is mentioned in subsection (1) of this section—

(a) subsection (1) of section three of this Act shall have effect as if the reference in that subsection to centres provided under the enactments specified therein included a reference to health centres provided under the law of the Republic of Ireland, and
(b) subsection (2) of the said section three shall have effect, in relation to a health centre provided under the said law, as if for the employment specified in paragraphs (a) and

(b) of the said subsection (2) there were substituted employment certified by the said Medical Registration Council or a body acting on behalf of that Council to correspond to the employment specified as aforesaid."

The Amendment should not take up time. It merely extends to the Republic of Ireland the same provisions that we have extended to health centres in England and Wales.

Amendment agreed to.

Further Amendment made: in page 5, line 26, leave out "in the medical register," and add "under the Medical Acts."—[Mr. Blenkinsop.]

Motion made, and question proposed, "That the Clause, as amended, stand part of the Bill."

Surgeon Lieut.-Commander Bennett: I asked on Second Reading whether the Republic of Ireland would be altering its medical curriculum in step with ours in order that the Clause might have full application. Clearly, if Ireland is not going to do so, we should have to make some alternative provisions. I think that the reply which I had on that occasion was that the Republic of Ireland was likely to do so, but there was nothing very conclusive about it. May I have an assurance that the Republic of Ireland will, in fact, be altering its medical curriculum in step with ours?

The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop): I understand that that is indeed the position.

Dr. Hill: I am not quite clear about the meaning of the last two lines of subsection (2). The assumption in the Clause is that the Republic of Ireland has passed similar legislation, and on that assumption, the Clause goes on to say:
No such person shall"—
after such legislation has been passed—
become provisionally registered"—
presumably, here—
unless he is registered by virtue of the said provision of the law of the Republic of Ireland.
The intention, it occurs to me, was that a man should not become provisionally registered here unless he is provisionally registered
by virtue of the said provision of the law of the Republic of Ireland.


I may have the point wrong, but it is important in the Bill clearly to distinguish between provisional registration and registration in every place. I ask the Parliamentary Secretary to explain the intention of the two lines I have quoted and to say whether the words fully express the meaning.

Mr. Blenkinsop: I will certainly look into that point and make sure about that. Obviously, we are trying to get the arrangements in both countries to run on the same basis, and I imagine that that is the position here. I will check it up before the next stage of the Bill.

Mr. Porter: I do not want to interfere in the discussions now taking place in the provinces, of which I have no particular knowledge, but I should like to ask the Committee to be very careful about the matter which has been raised, unless they have a full guarantee about it. When the law concerning trade unions was annulled in the House, some of us were anxious to find out whether. since Northern Ireland passed the original Act because we did, they would annul for like reason. Up to now, however, we have not got that satisfaction.

Dr. Morgan: I am still not quite clear. There is no provisional registration at present in Ireland. Therefore, if a man who is fully registered in Ireland comes to this country, as I understand the Bill, he will have to register here provisionally and then to serve his year of registration either here or in Ireland then he will be qualified to become fully registered on the complete register in this country. This is understandable, because otherwise the Irish graduate, being registered on the one register in Ireland, would be able to come over here and claim to be enrolled on the full register in Great Britain, and legally he would be entitled to do so according to the agreement between Ireland and this country.

2.30 p.m.

Mr. Blenkinsop: I do not want to emphasise the same point again, but, as has been made quite clear, the assumption is—and we have the undertaking that this will in fact be carried out—that there will be provision of provisional registration in Ireland as it will be provided here. Therefore, the point referred to by my hon. Friend will not in fact arise.

Dr. Hill: Will the hon. Gentleman allow his imagination to run riot for a moment without creating an international incident. Should it happen that because of circumstances over which we have no control and for arguments which we do not appreciate, the Republic of Ireland does not do this, would it mean that graduates from Ireland who find their way to the Irish register without an intern year, would be able, as the hon. Member for Warrington (Dr. Morgan) suggested, to come over here and, by the arrangement of reciprocity, find their way on to the British register, so stealing an advantage—if it is an advantage—over corresponding British graduates? Will the hon. Gentleman answer the question of what would be the position, should the impossible happen and the Republic of Ireland not pass the necessary legislation?

Mr. Blenkinsop: I hope no hon. Member of the Committee will invite me to make speeches about all the hypothetical possibilities which might conceivably arise and which the hon. Member for Luton (Dr. Hill) says will not arise anyhow. I agree with him that this will not arise but, should it arise, it would obviously be necessary to consider some amending Measure to deal with it. We have the very definite assurance that this is already being taken care of, but should there be such a difficulty we would have to come to the House again.

Question put, and agreed to.

Clause, as amended, ordered to stand part of the Bill.

Clause 7 ordered to stand part of the Bill.

Clause 8.—(AMENDMENTS AS TO MEMBERS OF COUNCIL CHOSEN BY UNIVERSITIES, COLLEGES, ETC.)

Mr. Blenkinsop: I beg to move, in page 6, line 5, to leave out, "in the medical register" and to insert "under the Medical Acts."
This is a drafting Amendment which, I think, was fully explained by my right hon. Friend.

Amendment agreed to.

Clause, as amended, ordered to stand part of the Bill.

Clause 9.—(INCREASE IN NUMBER OF ELECTED MEMBERS OF COUNCIL AND REVOCATION OF S.R. & O. 1909 NO. 916 AND S.R. & O. 1931 NO. 719.)

Dr. Stross: I beg to move, in page 6, line 14, to leave out the second "and."
I wonder if it would meet with your approval, Major Milner, and be to the convenience of the Committee, if this Amendment were considered together with the following two Amendments in my name—
In line 15, at end, to insert:
and
(c) in Northern Ireland and the Republic of Ireland shall be increased to two";
In line 25, after "Wales," to insert:
and of the persons elected in pursuance of paragraph (c) of the last foregoing subsection, one shall be elected as a person resident in the Republic of Ireland and one as a person resident in Northern Ireland.

The Chairman: The Chairman
indicated assent.

Dr. Stross: I am very much obliged. I think we are in agreement that any increase in the number of directly elected members of the Council is a desirable thing so long as the number is kept within reasonable bounds. As the Clause stands, the number is 10 and it is noted that two are elected from Scotland, eight from England and Wales and, in lines 24 and 25, there is a special mention of Wales. The wording is:
one shall he elected as a person resident in Wales;
I remember that on Second Reading my right hon. Friend wondered whether that was necessary. I think his sense of local feeling for Wales made him suggest that even if those words had not been inserted. Wales would have found it quite easy to contribute at least one member, even if no one had ever thought of it before, and certainly without the words being in the Bill.
I wonder, therefore, why we have not some similar reference to Northern Ireland and the Republic of Ireland. Is it because everyone expects that names like Moynihan and Mayo still so resound in our ears, that there can be no doubt that Northern Ireland and the Republic of Ireland will have proper proportions, because this matter will be raised in Northern Ireland and in the Republic? The Parliamentary Secretary told the

Committee that he thought everything was going on all right and that there would be no difficulty about reciprocity between the two countries. He suggested that legislation would follow on a par with what we are considering today. If that is the case, it seems all the more reason why the Minister should consider the Amendment I have put down.
In two ways I think the Bill might be improved by these three Amendments. First, there is the fact that the number of members directly elected would be 12 instead of 10 and in this respect I would bring to the notice of the Committee and the Minister this interesting and important point. In a Clause which we shall reach later we shall be discussing the question of illness or death of elected members and how their places shall be filled. There will be a time-lag, and I suggest there may well occur times when it will be difficult, as a result of death or illness, to maintain a full disciplinary medical committee in accordance with the defined constitution of that committee. That is all the more reason to push up the number from 10 to 12.

Dr. Broughton: I wish to support this Amendment. I cannot understand why Ireland has been omitted from this part of the Bill. Northern Ireland is a part of the United Kingdom, and in Belfast there is a great medical school. I should like to see Northern Ireland represented in this way.
During the Second Reading of the Bill my right hon. Friend the Minister said:
The General Medical Council still exercises some jurisdiction in relation to the Republic of Ireland, under an agreement entered into between the United Kingdom and the Irish Free State, as it then was, in 1927.
He went on to say:
It has, therefore, been necessary to enter into consultations with the Government of the Republic to ensure that the present arrangements outlined in the Bill are acceptable to them and that they for their part would similarly he willing to amend their own law as necessary."—[OFFICIAL REPORT, 27th June, 1950; Vol. 476, c. 2186-7.]
In the Debate on Clause 6 my hon. Friend the Parliamentary Secretary said that the assumption is that the arrangements in both countries will be on the same basis. If that is so, I think it would be not only a kindly gesture, but a very wise move to have an elected representative from the Republic of Ireland. That


would help to maintain the close cooperation which is desirable.

Mr. Iain MacLeod: In one or two sentences I wish to put forward reasons which I think are of weight against this proposal. First, on principle, I think it is a bad thing to have a sort of Dutch auction with all the competing interests for seats on this body.
Anyone who remembers the Committee stage of the parent Bill, the National Health Service Bill, will remember the interminable arguments for what one could call the vested interests. I know this suggestion is welcomed by the British Medical Association, which, for obvious reasons, is not surprising, but previously there were to be seven elected members on this committee, six for England and Wales and one represented Scotland and Ireland. The Bill originally increased the number to nine, and another place has made it 11. I should have thought that the time had come to call a halt to that process.
I very much doubt whether it is constitutionally proper to put into the Bill in the Committee stage such a suggestion in relation to a country which, apart from various statutory provisions, is virtually a foreign country. I do not think we can legislate in regard to a country which has entirely severed itself from us. I do not think we can put into our legislation, at least without prior agreement, a suggestion allowing them to put forward one extra nominee to the Council.
Finally, as the 1886 Act stands, there is already one representative of the whole of Ireland without division, because of course the Republic of Ireland and the province of Northern Ireland did not then exist. I see no reason why we should disturb an arrangement which requires them to agree on their representative. Almost the only other example of such agreement is their Rugby football team, which they select jointly. If they have an agreement that in ways best known to themselves they select a representative from Ireland in its geographical sense, I think that arrangement should stand. On grounds of numbers I can see a certain case for increasing the representation to two but that is not the point which this Amendment puts forward. It would be wrong and constitutionally improper to

suggest that one representative should come from each of the two constituent parts of geographical Ireland, and I hope that the Parliamentary Secretary will not agree to the suggestion.

Mr. Blenkinsop: I hope that my hon. Friend will not press this Amendment. It is the case, as the hon. Member for Enfield, West (Mr. Iain MacLeod) has said, that Ireland has always been a unity in respect of medical education. The hon. Member instanced the further example of Rugby football. We on our side would not wish to make any alteration in the present position. A further and rather more important point is that if we were to raise this matter now, we should have to re-open the agreement we have made with the Republic of Ireland, upon which the whole of this Bill is based.
We have had long and very friendly discussions with the Republic of Ireland and with their representatives, and we understand that this position is fully satisfactory to them. I feel that the only result of making any alteration now would be that we should have to enter into further discussions for which at this moment there is frankly not time. Nor do I think it would be desirable if we were to argue this matter on the basis of numbers. I am doubtful whether, even on that basis, the addition of a further member for Ireland could be justified. On these grounds, I hope that the Amendment will not be pressed.

Dr. Stross: In view of what the Parliamentary Secretary has said, and the reasons he has given, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause ordered to stand part of the Bill.

Clause 10.—(TERM OF OFFICE OF ELECTED MEMBERS OF COUNCIL.)

2.45 p.m.

Mr. Fort: I beg to move, in page 7, line 6, to leave out subsection (3).
This subsection provides for vacancies to be left should elected members die or otherwise vacate their office before the end of their full term of office. Of the 47 members of the Council only 11 are elected, and of that 11, at least six must


be on the Medical Disciplinary Committee. It seems to me to be important that this number of elected members should be maintained at full strength—there are not many of them—rather than let a vacancy by death or for other reasons remain for the best part of 12 months. Indeed, if several elected members of the Council died in the last 12 months of their term of office or retired for some reason during those 12 months, it might be exceedingly difficult for the Medical Disciplinary Committee to be properly and fully manned to discharge its duties.
Furthermore, by the terms of the consequential Amendment which we have put down, in page 7, line 26, to leave out from "resignation," to the end of line 28, it would be possible to put into operation the machinery for electing a new member to a vacancy before the end of the 12 months' period. I commend the Amendment to the Committee. It is designed to keep the relatively small numbers of elected members at full strength during the whole life of the Council.

Mr. Blenkinsop: While I appreciate the point which Members opposite have in mind in putting down this Amendment, and their natural desire to ensure that there should be at least six elected members available, I very much doubt whether it would be desirable to agree to this Amendment. In the first place the contingency which is visualised is highly unlikely. It assumes that 11 members are to be reduced to six within the last year of their period of office. I should have thought that almost inconceivable, but even if it were to happen, the committee would still be able to carry on its functions. I agree that it would mean that the number of elected members would be reduced, but there would be no automatic "seize-up" of the activities of the committee.
We must bear in mind the fact that the elections are expensive to carry out. It seemed to us reasonable that we should try to avoid unnecessary elections in the last year of the term of office. Although, as I say, I appreciate the point which hon. Members have in mind, I think that balancing it with the other factors and the extreme improbability of it ever occurring—

Dr. Morgan: Can the Parliamentary Secretary give us some idea of the cost?

Mr. Blenkinsop: Yes, I gather that the cost of an election to fill a casual vacancy in England, including Wales, would, on the basis of the latest experience be £1,245. The cost in Scotland would be a good deal less. I hope that suggests that this proposal may be regarded as unnecessary.

Mr. Pitman: Would the Parliamentary Secretary say whether the Irish doctors are happy about this, because they are in the peculiar position of having only one representative and in the circumstances envisaged by my hon. Friend the Member for Clitheroe (Mr. Fort) they might be without a representative for nearly a year? If they are satisfied, I shall be content with the Parliamentary Secretary's answer.

Mr. Blenkinsop: I understand that they are quite satisfied.

Mr. Iain MacLeod: Will the Parliamentary Secretary clear up one point? The question of cost is formidable if it be as real a point as that which the Parliamentary Secretary put forward. As I understand the matter, these members are not all elected together to serve for a particular period, so that to leave the vacancy would only postpone for a month, six months or, in an extreme case for between 11 and 12 months the expenditure of £1,245, which would in any case have to be expended. I may be on a wrong point but that is how it seems to me. if that be so, if that premise be sound, surely the Parliamentary Secretary will have to look at this again, because the method put forward is a great deal tidier and less cumbersome than the one at present in the Bill.

Mr. Blenkinsop: The expense involved is the expense of sending out ballot papers and so on, which is almost as great in sending out for one, as it is in sending out for many, when the general election takes place.

Lieut.-Colonel Elliot: I see the point as to the expense but if a member disapproved of something being done. there is the very powerful sanction of resignation. No one wishes to resign and merely allow the body to whose action he objects, to carry on without his presence—no one except perhaps Mr. Molotov. It seems to me to be a valid point that a person who disapproves can resign and thereby bring about a by-election.

Dr. Morgan: And stand again.

Lieut.-Colonel Elliot: He could stand again if necessary but he would produce a by-election and this procedure would avoid a by-election.

Dr. Morgan: In the last year.

Lieut.-Colonel Elliot: Well, there are times when a by-election is no bad thing, and it is part of the sanction of an elected member that he can refuse to take further part in the proceedings of the Council and refer the matter again to the judgment of the electors. This, for what it is worth, would deprive the electors of that chance to decide in the last 12 months. One can imagine cases where it might be desirable that such an election should take place, and I hope that the Minister will give this a little further thought.

Mr. Blenkinsop: Hon. Members should realise that it is still possible for six members either to resign, or for vacancies to be caused by some other reason, before this particular difficulty arose; and also it is only within the last 12-month period that it can arise. I feel, taking everything into account, plus the cost involved, that the present position is reasonable.

Lieut.-Colonel Elliot: I do not quite understand the point about "six."

Mr. Blenkinsop: Well, eleven down to six—five at any rate.

Lieut.-Colonel Elliot: I was making the point about the protest of an individual which might well be a protest against the action of the other five elected members; and to refer it to the electorate is the constitutional way of assuring oneself as to who is expressing the view of the persons represented. I wish the Minister would look at this again. He may put in something to the effect that if the member quitting office desires it should not be filled until the end of his full time of office. That would obviate the difficulty to some extent. But the Minister should give further thought to this because the purpose of the Bill is really to strengthen the position of the elected Member, and this is one of the ways in which a single individual member can disagree with all the others. Sometimes in affairs it is a case of Athanasius contra mundum. Sometimes it is Athanasius who is right and the rest

of the world wrong. It might well be that some obstinate and stubborn individual may be expressing a valuable point of view.

Dr. Morgan: I wish that the Parliamentary Secretary would consent to look at this again. The action of the Government is very peculiar. It is always being said that we want the professions to do their democratic work themselves, and now we are proposing to deprive them of an opportunity of so doing. The position is especially peculiar with regard to Ireland. Here we are asking that a man who has a legitimate grievance on one side ought to be able to give it prominence by resigning, and, as I said in an interjection, standing again to prove he is right. It is a little indiscreet of the Government having regard to the position in Ireland and I wish that the Minister would look at it again.

Mr. Blenkinsop: This is not a matter about which we wish to argue unduly. I am sure my right hon. Friend would be prepared to look at the point again, but I cannot give any sort of guarantee. I still think that, on balance, it is desirable that this position should be maintained.

Amendment, by leave withdrawn.

Clause ordered to stand part of the Bill.

Clauses 11 and 12 ordered to stand part of the Bill.

Clause 13.—(MEDICAL DISCIPLINARY COMMITTEE.)

Dr. Morgan: I beg to move, in page 8, line 6, to leave out "Disciplinary," and to insert "Penal Cases."
I do not wish the disciplinary committee to have anything to do with this. I wish the penal cases committee to investigate first whether there is a prima facie case for the accused person to answer and if the penal cases committee finds there is a prima facie case, then this Amendment asks that a certain procedure should be adopted. I want the word "Disciplinary" to be deleted, so that the committee will not have powers of discipline and will be a committee for investigating penal cases, with a view to discovering whether there is a prima facie case to answer.

Dr. Hill: This innocent-looking Amendment is aimed at the whole structure of


this part of the Bill. This recasting of the disciplinary machinery, and the establishment of a body smaller than the General Medical Council for this purpose, are among the most important parts of the Bill, and I hope that they will be left untouched.

Dr. Morgan: The hon. Gentleman is speaking against a committee of his own organisation.

Dr. Hill: I am expressing the views I hold, however they may conflict with those of anybody else. The Council has a penal cases committee which advises the President and sorts out the frivolous from the real complaints. Reference will be made to that in a later Amendment. The structure under which the penal cases committee, in consultation with the President, sorts out the complaints made against practitioners, and in addition to which there is a separate body which hears the cases, should commend itself even to the hon. Member for Warrington (Dr. Morgan). It certainly represents a considerable advance in the technique and methods of the General Medical Council.

3.0 p.m.

Mr. Bevan: I hope that my hon. Friend will not press this Amendment. This part of the Bill—and indeed all the rest of it—has been arrived at by general agreement with those concerned. This part of the Bill would be torpedoed if we accepted this Amendment. It must always be borne in mind that the function of the General Medical Council is to maintain, and even to raise, the general standards of the medical profession, and to protect the public—the two things together. Sometimes the last is forgotten and only the first remembered, and sometimes the first is forgotten and the last remembered. In holding the balance even, we have tried to provide the General Medical Council with the best procedure and machinery. I hope that at this late stage, we shall not make this major alteration.

Dr. Morgan: On principle, I cannot withdraw the Amendment. I do not wish the General Medical Council to have in their hands the power to take action for an alleged offence which may affect not only a man's career, but his wife and children who have to bear the burden of his removal from the Register, if the penalty is as big as that. I want that power to be taken completely out of their

hands. I suggest that they should have only the power of investigation, the power to say whether there is a prima facie case for a man to answer. If there is a case to answer, then it should go before another body which would try him properly. I am speaking, I think, to a decision arrived at by a committee of the British Medical Association of which I was a member, and I do not think that the hon. Member for Luton (Dr. Hill) was present. I am sorry to have to disturb the Government on this matter. I feel most strongly about it, and I cannot agree that the Amendment should be withdrawn.

Amendment negatived.

Clause ordered to stand part of the Bill.

Clause 14.—(CONSTITUTION OF MEDICAL DISCIPLINARY COMMITTEE.)

Dr. Stross: I beg to move, in page 8, line 28, after "five," to insert:
of whom two shall he elected members of the Council.

The Deputy-Chairman (Colonel Sir Charles MacAndrew): At the same time, it might be convenient for the Committee to discuss the next Amendment in the name of the hon. Member, in line 33, at the end, to insert:
of whom three shall be elected members of the Council.
and the Amendment in the name of the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot), in line 35, after "hearing," to insert:
at least two elected members of the Council and.

Dr. Stross: The purpose of the two Amendments in my name is simple and straightforward, and I hope that they will be accepted. We all agree that it is desirable to see an increase in the number of elected members of the Council. That is embodied in the Bill. Here we are dealing with a very important part of the machinery, the constitution of the Medical Disciplinary Committee, and its functions, and I therefore thought it proper to put in these small Amendments.
I am suggesting that, where the Committee normally consists of nine members, unless the circumstances are exceptional,—when the president or his nominee may increase the number—three members


should be elected representatives, and, since the quorum is to be five, I have suggested that two shall be elected members. There is probably common agreement about this, and I do not think there would be any difficulty in finding these proportions of two out of five and three out of nine.

Mr. Bevan: I am afraid my hon. Friend is asking me to give him a little too much. I am prepared to have a look at the second Amendment, but I could not accept the first, because it might be entirely unworkable. The assumption is that two elected persons must be present. We must remember what we are dealing with here. We are dealing with a situation in which the accused person is summoned to be present, along with any witnesses who support him, and they may have travelled very considerable distances; yet, because of some reason over which neither the accused nor anybody else has any control, if two out of the five persons are not elected representatives, the proceedings cannot go forward. This is administratively an exceedingly difficult principle to operate, and I therefore hope it will not be pressed. After all, we have gone a very considerable way here in increasing the number of elected members. Surely, it is the duty of elected members to attend, and we ought not to impose a hardship or victimise those who have to be subjected to these proceedings if the elected persons do not do their duty.
When we come to the other Amendment, it is very much easier, because the idea is to ensure that the nine members who will be invited to hear most of the disciplinary cases might include three elected members. That is all right. Here we have an invitation, but in the other case it was a statutory command, and the two do not run together. I hope my hon. Friend will withdraw his first Amendment, and, if we are taking the two together, I will accept the second in principle.

Surgeon Lieut.-Commander Bennett: Since the Amendment in the name of my right hon. and gallant Friend the Member for Kelvingrove (Lieut.-Colonel Elliot) is being discussed with those of the hon. Gentleman opposite and is concerned with substantially the same point,

I should like to draw attention to its purely permissive quality, as compared with the compulsory nature of that of the hon. Member for Stoke-on-Trent, Central (Dr. Stross).
It is clear that the elected members are a most valuable element in the constitution of the disciplinary committee, because the members of the General Medical Council, by and large, belong to very academic and learned bodies which in practice take different views on the various forms of misconduct. The Minister has stressed the point that the proceedings would come to a standstill in the absence of the requisite number of elected representatives, if their attendance was compulsory and if they were to be a certain proportion of the whole. The Amendment in the name of the right hon. and gallant Member for Kelvingrove, to which my name is attached, would provide that at least two elected members should sit, but that the proceedings do not fall down if they are not present.

Mr. Bevan: The remarks I made on the second Amendment apply also to this one. We are prepared to accept it in principle, although, perhaps, we should put "two" instead of "three."

Dr. Stross: Finding myself quite convinced by the Minister and accepting his compromise, I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

The Deputy-Chairman: I do not propose to call the Amendment in page 8, line 39, in the name of the hon. Member for Warrington (Dr. Morgan) because it is inconsistent with the decision arrived at on an earlier Clause.

Dr. Morgan: Did you say, Sir Charles, that the decision on the earlier Clause was against my Amendment on this Clause?

The Deputy-Chairman: I am afraid the Amendment is inconsistent with the decision arrived at on Clause 13.

Dr. Morgan: With great respect, Sir Charles, I submit that this Amendment is entirely different from the first one. It is asking that the disciplinary committee should be called the "penal cases committee." It is a very special committee.

The Deputy-Chairman: I am afraid that as it was only put on the Order Paper this morning, I did not have time to study it properly. I thought it was out of order.

Dr. Morgan: With great respect, Sir Charles, there are other Amendments which were only put on the Order Paper today, and which have been selected. I am sorry that you have decided not to select mine. I took careful advice from three lawyers about it, and I am sorry that your opinion, Sir Charles, differs from theirs.
Motion made, and Question proposed. "That the Clause stand part of the Bill."

Mr. John Hay: I wish to raise a point about subsections (4) and (5). Subsection (5) provides that:
All acts"—
which I assume include decisions of the Committee—
shall be decided by the votes of a majority of the members present at any meeting.
Subsection (4) provides that the constitution of the Committee for the purposes of proceedings of that sort is to be nine members. I think we agree on both sides of the Committee that very special powers are being given to the medical disciplinary committee. They are really acting as a kind of jury on matters which may easily result in the complete barring of an individual practitioner from carrying out the duties of his profession. It may mean professional suicide for a man if he is found guilty of committing professional misconduct.
With such consequences hanging over his head, I think it is inappropriate that the majority of the votes of the Committee should decide his fate. After all, a man can be charged in this country with a minor criminal offence, such as driving a car without due care, and the jury's decision must be unanimous. If we insist in our law that a person can only be convicted on the unanimous verdict of 12 people, I think it is very wrong that we should decide that a person may be debarred from carrying out the performance of his profession by a mere majority vote. I ask the Minister to look at it again. I think that up to the present it has been the practice to decide by a majority vote. I have always thought that to be wrong. and I hope the Minister will think that a provision should be inserted in the Bill stating that such cases must be decided

on the unanimous vote of the body concerned.

3.15 p.m.

Dr. Morgan: On the Question, "That the Clause stand part of the Bill" I should like to refer to my Amendment which you, Sir, unfortunately ruled out as being not appropriate or out of order.

The Deputy-Chairman: I must remind the hon. Member that he cannot talk about his Amendment now.

Dr. Morgan: Surely, I can call attention to omissions from the Clause and say I am sorry that certain things are not in the Clause and deal with certain things that are in it.

The Deputy-Chairman: No, the hon. Member cannot deal with omissions from the Clause. He can deal with what is in the Clause.

Dr. Morgan: Then, I want to discuss the question of this General Medical Council having the right to have a special disciplinary committee to try a man in this way. This is simply a prolongation of the present system. Let me recall a case I was interested in a long time ago—the case of Dr. Hennessey practising in Leatherhead. He was charged by a patient with a certain unethical action towards her. That woman made a sworn statement in a charge against him to the General Medical Council. The Council took action. They tried him and heard him, and then decided that he was unfit to remain on the Register.
Let me tell the Committee what I have actually seen on the General Medical Council. I have been present at hearings by the Council, because I have always been interested in this body. On one occasion when I was present every member was over 65. Some were nearly blind, and certainly some were deaf and, I am sorry to say, a deaf one was appointed by the British Medical Association.

Dr. Hill: Is the hon. Member suggesting that any member of the Genera! Medical Council is appointed by the British Medical Association? As a member of the council of that body he should get his facts right.

Dr. Morgan: Six members are elected and this was one of the members submitted by the B.M.A. to the electorate,


and they nearly always get in. But what is the good of interrupting on a trivial point like that?

The Deputy-Chairman: Whether it is trivial or not, this has nothing to do with Clause 14.

Dr. Morgan: Surely, I am entitled to say what they are able to do under Clause 14. I am talking about what is included in the Bill. Surely, it is utterly hopeless if men of that type are to adjudicate in what is really a court, and are to try the question of whether a man is to be registered or not. Frequently, when they have met they have gone and had tea for 10 or 15 minutes during the trial.

Mr. Hastings: Why not?

Dr. Morgan: Because judges trying cases do not usually go out to have meals and keep the court waiting, and then come back to continue the trial.

Dr. Stross: They do.

Dr. Morgan: I have never seen it done. However, let us come back to this case. A charge was made against this man. They tried him in this peculiar way, and they struck him off the Register. He had no right of appeal. His practice was ruined, his wife suffered. He had no cash coming in, and he could not sign a medical certificate.
Someone advised this honest, decent, excellent doctor to charge this woman with slander and libel, and that case was taken to court. Mr. Justice Charles could not ascertain why this lay person, not very well educated, was able to quote professional terms in the course of her evidence. I was there at the time. He said. "Can anybody give me an explanation as to why this lay person is using professional words in describing what she saw of this man's person when he was alleged to be assaulting her?"
The wife of the accused gentleman said, "I can explain." She was called to the witness box and gave evidence that this person was an experienced typist, and that she had seen her taking down the evidence as given to the British Medical Council by the professional man who had examined the accused. She was using the word "cicatrix" for "scar." The judge said

that a young woman of this type of education did not use that word for "scar." [Interruption.] I do not know whether I have pronounced the word wrongly or not, but that was what I was taught in my college, after I left school—a very poor school; almost as poor as the one from which the Minister came.
As a result of the evidence, Mr. Justice Charles found in favour of Dr. Hennessey, and awarded him £2,000 damages. The case came up again for hearing by the committee of the G.M.C., and 113 was reinstated on the register. I am trying to point out that under the system which is to be perpetuated now, laymen, without any knowledge of the law and of hearing evidence, and without any knowledge of balancing evidence with legal procedure, are in a position definitely to outlaw a man from society and his profession. Because of that, I protest against this Clause being in the Bill without Amendment and without further consideration of how it should be amended to bring it into line with the ordinary canons of justice, decency and professional consideration for a man who is trying to do his work well.
This man was reinstated. No further charge was made against him. He is doing very well and remaining on the register. I protest, as a matter of principle, against this body being allowed to condemn a man for life in his professional career.

Mr. lain MacLeod: I want to refer to a point made by my hon. Friend the Member for Henley (Mr. Hay), with which I am in entire disagreement. The two matters which he raised were both put into the Bill in another place. First, the Amendment designed to ensure that not more than nine members of the committee should attend was put in on the principle, which is an excellent one, and mentioned in another place, that one cannot get justice from a mob of judges. Secondly, I think that the analogy with a jury is entirely false. I can see no valid comparison whatever there. A most useful Amendment put in this Bill in another place now ensures that this disciplinary committee can give a verdict of "not guilty" instead of the most unsatisfactory one of "not proved." With those two Amendments, which are a great improvement to the Bill, I think that we should rest content.

Mr. Hay: I see that, according to subsection (5), all acts of the committee shall be decided by the votes of the majority of members present at the meeting. It by any chance the votes should be even, does this provision not exclude the casting vote of the chairman? In the case of the vote being four to four, am I right in assuming that no decision can be reached?

Mr. Bevan: Yes, Sir. May I ask the Committee to try to get ahead a little faster? This is supposed to be an unopposed Measure, and I do not want to repeat some of my previous experiences, that when a Bill is unopposed h immediately becomes contentious. There is not very much to be said in reply to what has been raised on the Clause. It must be borne in mind that the president, or anyone acting on his behalf can, if he considers a particular case sufficiently serious, important or far-reaching, have it tried by the 19 members. That is a sound protection.
I entirely agree that we cannot normally have cases tried by a large number of persons. I would remind the Committee again that there is now an appeal. The whole scene is changed by what we are doing in the Bill. Members are addressing themselves more to the protection of the doctor. We must also bear in mind that this body is charged with the discipline of a profession that is in the most intimate relationship with the public, and that the standards of the profession must be maintained and improved. The Bill goes much further in the protection of the doctor than the previous procedure, while at the same time holding the balance even for the general public.

Mr. Hay: I do not want to delay the progress of the Bill. My point was not connected with the nine members, but to a decision being reached by a bare majority. I think that, as in the case of the jury, a decision should be unanimous.

Mr. Bevan: Having had some experience of the principle of unanimity in other fields of human activity, I think that this is the very last place in which we ought to introduce it. If we did and one person disagreed, then the committee could not do its work of protecting the public. I am looking at the matter from the point of view of the person against whom a charge has been made. He is

first of all screened, and then his case is investigated. If the majority of his peers consider him guilty, the principle of unanimity would mean that one person could deny the protection which the public ought to have. That, surely, tilts the whole balance the other way. I think that the individual concerned is adequately protected.

Dr. Morgan: May I make a personal explanation? The Minister remarked just now that this is an agreed Measure. May I point out that I have spoken with the permission of the appropriate authority of my party, and that in that sense this is not an agreed Bill. Before I took any action in regard to this Measure, I went to the authorised persons in my party and laid the facts before them, and the liaison committee gave me permission to oppose the Bill on these special points, but did not give me the power to vote against it.

Mr. Hastings: May we know what committee of the House is the liaison committee?

The Deputy-Chairman: As I am not the chairman of that committee, I do not know.

Dr. Morgan: I did not say that it was a committee of the House but of my party.

Question put, and agreed to.

Clause ordered to stand part of the Bill.

Clause 15.—(PROCEDURE OF MEDICAL DISCIPLINARY COMMITTEE.)

3.30 p.m.

Lieut.-Colonel Elliot: I beg to move, in page 8, line 40, after "of" to insert:
exercising the functions assigned to it under this Act, the Committee shall appoint a subcommittee of its members to be called the Penal Cases Sub-committee, to investigate each complaint made to, or information received by, the Committee, and where the sub-committee are satisfied that a prima facie case for inquiry has been established they shall refer the matter to adjudication by the Committee, but where they are not so satisfied no further action shall be taken in regard to such complaint or information; and the Committee shall make arrangements for securing that no member of the Committee shall attend for the hearing of any case who has taken part in the proceedings before the Penal Cases Sub-Committee upon that case.
(2) For the purpose of.


The Committee has decided in Clause 13 that there should be a medical disciplinary committee and in Clause 14 what its constitution should be. This is a small point of procedure. We suggest that the penal cases committee, which has existed informally since 1894 should become statutory; and secondly, that anyone who has considered the case in the penal cases committee should not sit to hear the case in the disciplinary committee. I trust that the Minister will be able to concede those points to us.

Mr. Bevan: This Amendment falls into three parts, and the third is the one we cannot accept. As I understand it, the first is to formalise, by covering with a statutory provision, the preliminary stages of the investigation of complaints. This we accept in principle. The idea is that those who have already taken part in screening have a tendency to prejudge. The second part is to prevent any overlapping in the membership of the penal cases committee and the medical disciplinary committee. It is understood, however, that the president would be allowed to attend both.

Lieut.-Colonel Elliot: Oh, yes.

Mr. Bevan: The next is to prevent any complaint against the practitioner being investigated unless supported by a formal written complaint or a statutory declaration. This we consider objectionable, because, supposing for example that it was desired to call the attention of the disciplinary committee to charges made against a general practitioner, we would not want to be the complaining—

Sir H. Lucas-Tooth: On a point of order. Is the argument to which the right hon. Gentleman is addressing himself not really the argument contained in the next Amendment but one, namely. the Amendment to page 9, line 29, and not this Amendment? I do not think that that particular point is raised in this Amendment.

The Deputy-Chairman: This and the two following Amendments, in page 9, line 29, could be taken together.

Dr. Hill: With great respect, there is a different point in the third Amendment.

The Deputy-Chairman: That is so.

Lieut.-Colonel Elliot: I think the Minister conceded the two points in this Amendment, and the further point is one which we could consider when we get to it. I think we can make progress now, because I take it that the Minister agrees in principle to what we have put forward on this Amendment.

Mr. Bevan: Certainly.

Lieut.-Colonel Elliot: If that is so, we shall be ready to withdraw the Amendment. He agrees, firstly, to a statutory cover for the informal committee which previously existed in some form or another; and, secondly, to ensuring that a person taking part in the screening, as he called it, should not take part in the judging. If those two points in this Amendment are accepted in principle, I shall be glad to withdraw the Amendment.

Dr. Stross: That means that the Minister agrees with paragraph (f) of my Amendment, which is next on the Order Paper, namely, in page 9, line 29, at end, insert:
(f) for ensuring that a member of the Disciplinary Committee shall be disqualified for serving in that capacity in any case on which he has already acted as a member of another Standing Committee of the Council, to determine the existence or absence of a prima facie case to warrant a disciplinary inquiry; and
(g) for ensuring that an investigation of a complaint against a practitioner shall not proceed in the absence of a formal written complaint except in matters arising out of the findings of a court of law.
It also means he does not, apparently, agree to paragraph (g).

Mr. Bevan: Not to (g).

Dr. Stross: May I have permission to speak on paragraph (g)?

The Deputy-Chairman: We had better dispose of the first Amendment first.

Lieut.-Colonel Elliot: I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Dr. Stross: I do not press paragraph (f) in my Amendment.

Sir H. Lucas-Tooth: On a point of order. The Amendment of the hon. Member for Stoke-on-Trent, Central (Dr. Stross) refers to a point raised in the last Amendment and a point raised in the next Amendment to line 29. The Committee has decided we shall not accept


the principle in the first half of this Amendment, and it therefore falls. The second principle is the point which is raised in the Amendment in the name of my right hon. and gallant Friend the Member for Kelvingrove (Lieut.-Colonel Elliot). That Amendment should be moved and seconded, so that the Committee will be in order in discussing the point which the hon. Member for Stoke-on-Trent, Central, wishes to stress.

The Deputy-Chairman: That is what I was about to say.

Dr. Hill: I beg to move, in page 9, line 29, at the end, to insert:
(f) for securing that no complaint or information investigated by the Penal Cases Sub-Committee, other than a decision in a court of law, shall he referred to the Committee for adjudication unless the circumstances upon which such complaint or information is founded shall have been verified by statutory declaration of the person making the same, or, where such complaint is made or such information submitted by any public department, authority, or other body, by statutory declaration of an officer of such public department, authority, or other body, duly authorised for the purpose.
The purpose of this Amendment is to secure that the almost uniform practice of the General Medical Council, that there must be a statement by the complainant, becomes the uniform practice. I say "almost uniform" because there has grown up in the last few years a habit on the part of Government Departments, including the Department of which the right hon. Gentleman is the head, of not complaining but of sending the papers along in the hope that the General Medical Council may do something about it. That has happened. I could give the right hon. Gentleman examples. All I want to secure by this Amendment is that, whether the complainant be an individual, a body or a Government Department, there is a complainant and that there is a formal complaint which goes to the General Medical Council—no more than that.

Lieut.-Colonel Elliot: On a point of order. I believe there is no great weight in the remaining business on this Bill, and with hearty co-operation we could still conclude the Bill before the Committee rises. It would have the great advantage that it would enable the Bill to be reprinted and the Report stage Amendments which the Minister has un-

dertaken to make to be submitted in print, and not in manuscript as they might have to be if we had to conclude the Committee stage and then go straight on to the Report stage. We on this side will bind ourselves to secure that cooperation because nothing could be more important than to have the Bill clearly before the House on the Report stage with the Amendments of the Minister set down on the Paper.

Mr. Bevan: I am much obliged to the right hon. and gallant Gentleman and I sincerely hope that we shall get the cooperation of everyone in the Committee to accomplish that result.
I must resist this Amendment. I regard it as an exceedingly serious Amendment because what is now suggested is, for example, that the disciplinary tribunal under the National Health Service cannot call the attention of the General Medical Council to evidence placed before it unless it itself makes a complaint. That is an exceedingly dangerous thing to suggest. It means that the disciplinary committee of the General Medical Council would be an arbitrator between the doctor and a Government Department. That, in the first place, puts us in an entirely false position.
It does not follow that the Ministry of Health in this case should come to a conclusion about the doctor at all. It merely means that in the exercise of the administrative duties placed upon him under the health Statutes, the tribunal has brought to light evidence that would appear on the surface to be evidence that the General Medical Council should see, in order to make up its mind whether or not it should consider putting its disciplinary machinery into motion. That would seem to me to be a reasonable protection for the public, but it would not be reasonable to expect the Minister of Health himself to have a preliminary investigation on matters really falling within the jurisdiction of the General Medical Council's disciplinary machinery, and pre-hearing the case. [Interruption.] That is what is involved; that is the whole difficulty.
All we desire to do at the moment is merely to put such information as we have, not privately, secretly or covertly, in the possession of the General Medical Council, but in the ordinary way, saying,


"This is part of the evidence which we had before our tribunal." Having sent it to the General Medical Council, we are finished with it, and it is for the General Medical Council's disciplinary committee itself to decide in the light of the evidence.

Dr. Morgan: To hold the baby.

Mr. Bevan: I wish that my hon. Friend would try to restrain himself. He has had a pretty good innings today. We are engaged in a very serious matter and he ought to accept at this stage that the Committee do not agree with him. Therefore, the right thing to do is to try to make the remainder of the Bill as workable as possible.
The Amendment now before the Committee is a suggestion that unless any Government Department having doctors directly connected with it, is prepared to make a formal charge against a doctor and to support it, it cannot bring to the notice of the General Medical Council any evidence which it has against a doctor. That, surely, is a situation we cannot possibly accept, and I do not think, that the Committee ought to ask the Government to accept it. Take, for example, the operations of the National Health Service, which calls to light in the ordinary processes of its administration a vast weight of evidence. Ought not that evidence to be made available to the General Medical Council with respect to any medical practitioner if it feels that the G.M.C. ought to know? I should have thought it was an essential condition for protecting the general public.
The public will be listening to this discussion and will be anxious to find out what we are doing for their protection. I think that it is quite unreasonable to ask us to formalise the complaint—indeed, it is not a complaint; no one would be making a complaint against the doctor. We should only be making available certain facts that come to light in the course of the operation of the disciplinary machine of the National Health Service.

Surgeon Lieut.-Commander Bennett: Surely, the Minister is rather cutting across the proceedings of two different bodies for two different purposes. Surely his committee for maintaining the discip-

line of the National Health Service can make such rulings as they think appropriate with regard to the behaviour of a practitioner in the service and, if necessary, bar him from it; but when it is a matter of completely depriving a doctor of the right to practise, the information which has led to the complaint should not merely pass in a sort of backhanded way, without any covering message, to the General Medical Council. If there is a charge which may result in a doctor being prevented from practising altogether, there should be a specific charge laid against the doctor with the evidence to support it, not just a lot of evidence leading nowhere.

Mr. Bevan: The National Health Service is concerned with the contractual obligations of a general practitioner and not with his status as a doctor; that is the concern of the General Medical Council. Supposing a complaint has been laid against a general practitioner to an executive council. The local medical committee have examined it, and there is a complaint of negligence—that is to say, it is a complaint falling within the jurisdiction of the disciplinary machinery of the National Health Service.
Suppose in the course of the investigation of that complaint the evidence would appear to show that the doctor had been drunk on several occasions, although his drunkenness had only impinged itself, in the case of the National Health Service, in respect of one complaint of negligence that we are bound to investigate. Does the hon. and gallant Member suggest that there would be anything wrong in sending to the General Medical Council information of alleged drunkenness by that doctor so that it might be investigated? Does he suggest that the Minister of Health should first investigate the charges—there are no charges of drunkenness at that stage—lying against the medical practitioner and then pre-judge the case and make a formal charge against the general practitioner before we can protect the public against the doctor and ask for the charge to be investigated?

3.45 p.m.

Surgeon Lieut.-Commander Bennett: Surely the right hon. Gentleman is rather mistaken in what is required beforehand if he suggests that it is necessary for the


Minister to investigate the case. Surely if the Minister is convinced there is a charge, he should lay a charge to be investigated by the General Medical Council.

Mr. Bevan: No, that is the whole difficulty. The Minister ought not to be asked to load the case against the general practitioner by first so formalising the case as to investigate the charge of drunkenness, assemble all the papers and evidence and thus become an accuser of the general practitioner before the General Medical Council. That is surely an entirely wrong procedure.

Surgeon Lieut.-Commander Bennett: Surely it is better that the Minister should be the accuser than the informer.

Mr. Bevan: When the hon. and gallant Member is speaking of a Minister, charged by Parliament with the administration of the National Health Service and the public purse, it is a monstrous misuse of language to say that the information he sends to a public body must be brought against the accused person as coming from an informer. I am afraid that the professional occupations of hon. Members are overlaying their duties as Members of Parliament.

Surgeon Lieut.-Commander Bennett: Surely the duty of the General Medical Council is to protect the public; the Minister has to protect the Service, and if he wishes to bring a charge against the doctor of not being a proper doctor, he should make a charge and not more or less anonymously send information.

Mr. Linstead: I recognise that we are working against time and it looks very much as though we shall not do what we all hope to do, finish the Committee stage today. I have some sympathy with the point of view expressed by the Minister, because I have had a good many years on a similar professional tribunal.
I can understand his desire to send the papers to the General Medical Council. Take another example, I can understand an ordinary member of the public desiring to make some complaint against a doctor being content merely to send a complaint to the General Medical Council and not being prepared to spend a lot of money following that up, instructing a solicitor and instructing counsel,

maybe, in order to formulate it in proper legal form and pursue it before the disciplinary committee. But, if the Minister is to justify that state of affairs, I think he must tell us in a little more detail, perhaps on the Report stage, what machinery exists within the General Medical Council's office for investigation and for the proper formulation of the complaint eventually in such a way that a doctor will be faced with a properly formulated charge.
I do not think it is enough that the papers are sent in and disappear into the machine. I do not think it is enough to leave the public entirely at the mercy of some unknown machine when they write a letter. We ought to be told, if we accept the Minister's point of view, what happens to that file of papers and by what machinery it is finally turned out as a properly co-ordinated case, an understandable case with which the defendant can deal.

Mr. Hay: With all respect to the right hon. Gentleman, I think he has possibly misunderstood a great deal of the point of the Amendment. What my hon. Friend is saying is that when a Government Department, which in practice means the National Health Service, has in its knowledge certain information which might possibly lead the General Medical Council to investigate the way in which a certain practitioner has been carrying on his job, they should not just "send the papers" to the General Medical Council but should put them into some sort of proper form. In other words, some responsible official, possibly of the National Health Service, should be prepared to swear a statutory declaration saying—with the papers annexed, if necessary, to the statutory declaration—that this, that or the other has come to the notice of the Government Department, or the official concerned, and that these are passed on to the General Medical Council.
The right hon. Gentleman has quite rightly stated on a number of occasions during the course of the Committee stage of this Bill that we have to remember that we are protecting the general public. May I remind him and the Committee that we also have to bear in mind the protection of the individual practitioner concerned? We must do common justice to


him too. It is very bad practice indeed for a Government Department to "send the papers" as it has been put, to the General Medical Council without any definite statement of a charge which may have been laid against a particular individual.
The definite statement of a charge is accepted in practically every other form of judicial procedure in this country. If I think that someone else has committed a crime against me, for example, stolen my property, my duty is to go to the police and eventually to the magistrates' court, lay information, take out a summons if necessary and be prepared to give evidence and state what the facts are which caused me to believe that someone had stolen my property. That is all we are asking in this Amendment. We are asking that, just as the ordinary person must make a complaint in proper written form, so, when the General Medical Council is embarking upon an investigation, there should be exactly the same procedure when the complainant is really a Government Department.
The right hon. Gentleman sees some administrative difficulties. Nothing that we wish to do here is intended to make those difficulties greater, but I say that in common justice to the individual practitioner, who may be quite wrongly accused by some person whom he is treating under the National Health Scheme, something along the lines of our Amendment should be incorporated in this Bill. The present practice seems to me extremely unjust to the individual practitioner. We are only asking here for something analogous to every other form. of criminal or judicial procedure of which I can think in this country.

Dr. Stross: I put down my Amendment on this matter quite a long time ago. It is as follows: in page 9. line 29, at end, insert:
(f) for ensuring that a member of the Disciplinary Committee shall be disqualified for serving in that capacity in any case on which ha has already acted as a member of another Standing Committee of the Council, to determine the existence or absence of a prima facie case to warrant a disciplinary inquiry; and
(g) for ensuring that an investigation of a complaint against a practitioner shall not proceed in the absence of a formal written complaint except in matters arising out of the findings of a court of law.

The Amendment falls into two parts, one of which I think the Minister has accepted in principle, namely, that the screening committee should not become the executive committee and judge the cases. With reference to the second part of my Amendment, the substance of which is now under discussion, X was under the impression that my Amendment asking that there should be a formal written complaint except in matters arising out of the findings of the court of law, was a good and proper thing.
Having listened to the Minister and to the arguments, I have come to the conclusion that all we should do if I succeeded in getting what my Amendment asks for, would be to bring against the individual medical man a great and powerful machine instead of leaving things as they are and allowing that machine to send in information or papers, as the procedure has been termed, and leaving it to the good sense of the Penal Causes Committee to reject or reconsider and pass on, after which I gather that the individual accused will have his full right of notice, and papers will have to be produced, etc. In those circumstances. I do not wish to proceed with my Amendment.

Lieut.-Colonel Elliot: Will the Minister look into this point between now and the Report stage? It is clear that we shall not be able to finish the Committee stage of the Bill this afternoon. The point under consideration is one of some substance and several of my hon. Friends still wish to continue its examination. If the Minister were to agree to look into the matter, that would give us another opportunity later of considering the point. One does not like an Amendment hanging over for further debate on the next occasion when we consider the Bill.

Dr. Hill: So far as the Minister has referred to a decision in the tribunal dealing with matters within its field going to the General Medical Council in case there are other and wider professional implications, I accept what he says. Let me tell him what has happened. Allegations have been brought against the practitioner and they have gone through his own machinery and culminated in the rejection by the tribunal of the allegation. Then the papers, which could only relate to matters within the field of his own tribunal, have been sent to the General


Medical Council. In other words, there having been failure to secure the lesser verdict of removing him from the Service, they have tried the other way to obtain the higher verdict of removing him from the register altogether.
That is the point which I hope the right hon. Gentleman will look into. I agree with him that if the tribunal has decided on a particular issue, there may be a wider implication in the decision which will go to the General Medical Council, the tribunal having rejected the complaint in entirely different circumstances.

Mr. Bevan: I doubt very much whether the case is as the hon. Member has described it. It would seem to me that in such a case what would happen would be that the tribunal, having found that, so far as the contractual relationship of the doctor with the Service was concerned, nothing could be proved against him, would find for the doctor. But it does not follow that there would not be charges against the doctor which would expose him to action by the disciplinary committee of the General Medical Council. One does not necessarily assimilate the other.
I shall have a look at the matter, but as I have explained to hon. Members, I hope they will not press me too far, because I can assure them that once they ask a Government Department to formalise evidence against the general practitioner, they are discriminating against the general practitioner in the most dangerous way.

Mr. Hay: Mr. Hay  indicated dissent.

Mr. Bevan: The hon. Member for Henley (Mr. Hay) shakes his head, but he must learn to be a little more administrative and less juristic in this matter. Whoever he may be, the Minister of Health has the obligation of defending the public and the competence of his own machinery in this matter, and he may have to formalise the evidence, in which case the medical practitioner starts off before the General Medical Council with very heavy artillery against him. Surely that is not a desirable thing to do. It would mean that two trials would have to take place and the trial of the General Medical Council would be after the preliminary trial which had taken place in the Government Department.
I hope that hon. Members will not press this Amendment. We have done very well so far and up to now I have been my most conciliatory self. I suggest, especially as there is a specialised interest in this, that hon. Members should keep in mind the general duties of Parliament to protect the interest of the public as a whole, and I hope that they will not press this Amendment at this stage.

Mr. Pitman: I have no professional interest in this matter, but it seems to me that it is really an onus on the particular patient concerned, and any investigation and charge in that respect must have reference to a patient or a number of patients, and that the Minister should be neutral. He has no need to put his big machinery into effect unless the individual feels there is a sufficiently compelling reason to justify him prosecuting the doctor through the machinery of the General Medical Council and. the disciplinary committee. That seems to me to be the real essence of the case. It is not so much the Minister and his machinery as the individual patient—

It being Four o'clock The CHAIRMAN left the Chair to report Progress, and ask leave to sit again.

Committee report Progress to sit again upon Monday next.

HOUSING (LOCAL AUTHORITIES' ALLOCATIONS)

Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Kenneth Robinson.]

4.1 p.m.

Mr. Alport: It has been made abundantly clear how gravely we on this side of the House regard the continued failure of the present housing policy to match the needs of the nation. I believe that the position will continue to stagnate until those in charge tackle it with the fervour of engaging in a social crusade. I have continued to be amazed at how complacently hon. Gentlemen on the back benches opposite accept the assurances of the Minister that nothing more than is being done can be done. All I can say is that something better must be done. The right attitude is that which animated one of the famous armies


during the last war which took as its slogan:
The difficult we do immediately:
The impossible takes a day or two longer.
It is not only the failure of the general housing policy which we on this side condemn. There also appear to us to be certain administrative weaknesses, to one main aspect of which I should like to call attention this afternoon. On two occasions I have asked the Minister of Health for details about the basis on which the allocation of the houses to local authorities is made. His replies on both those occasions seem to be vague and even evasive.
On 20th April, he said:
Within the limits of the total programme, allocations to individual local authorities are made in the light of the current evidence available as to the relative housing need and building progress."—[OFFICIAL REPORT, 20th April, 1950; Vol. 474, c. 309-10.]
Later, I asked him how far the resources of the building industry are taken into account, and how these are estimated. He replied that one of the factors taken into account was the availability of building labour for housing work as estimated from progress on current contracts and in the light of employment statistics. If the Parliamentary Secretary can persuade his Minister to be a little more precise in answering the Questions which are put to him in the House, he might not find his Friday afternoons occupied so frequently by Adjournment Debates.
How is need estimated? Are local housing lists provided by the local authorities used? If so, why cannot the Minister give to this House, as he has been asked to do on numerous occasions, a reliable estimate of the total number on the housing lists in this country? How can he break down the allocation of 200,000 houses a year among local authorities fairly if he has no idea of the total need? If he is using the numbers on the housing lists of the various local authorities, how does he square that with his allegation that those figures, when totalled, are misleading and include a great deal of duplication? If he is not using these figures at all, because of that, then what is he using as a yardstick of local need?
There are only three possible conclusions. The first is that the Minister is

withholding the information about total housing need for political reasons. He knows that if he did produce the figures, they would show housing to be a far more serious social problem than unemployment was before the war. The second is that he is using figures as an indication of need in which he has no confidence, and that seems to me to point to gross administrative inefficiency. There is a third possible conclusion, and that is that he has no proper basis of estimating need at all as between the various local authorities, in which case his claim that need is taken into account has no genuine foundation in fact.
If that is true, the sooner we have a nation-wide inquiry into the housing needs of all local authorities the better, because hon. Gentlemen opposite are always claiming that they are the planners, and they should by now have learned that they cannot plan effectively unless they have available to them the full and accurate statistics upon which their plans are to be based.
The truth of the matter is—and no doubt the Parliamentary Secretary will correct me if he considers that I am wrong—that the prime factor governing the size of the allocations to individual local authorities is what one would call housing progress—the number or the percentage of the allocation of council houses which have been put out to contract by the local authority concerned and completed by them. That method, with the strict ratio between private enterprise houses and council houses which has been established by the Minister, operates against the interests of the smaller country districts and in favour of the large cities and towns. The reason is that in the country, direct labour building, even if it were desirable, and in my view it is not, is quite uneconomic, and building by contract is far more difficult in the country districts than in the great towns. That is, the building industry in the countryside is organised primarily on the basis of small concerns, and the small businesses in the building industry are unable, and in many cases unwilling, to undertake the obligations and responsibilities which the Ministry's housing contract imposes upon them.
The result, therefore, is that the placing of contracts in the country areas is slower than it is in the large towns and


cities; and, because there is still insufficient incentive to small men in the country areas and insufficient flexibility in housing policy as a whole, the local authorities in the country areas are frequently penalised because they have been expected to get their full number of houses contracted for, and because they have not been able to do that their subsequent allocations have been cut down.
I would like to give an example of this. In one rural district council area I know, the number of people on the waiting list on 1st January, 1948, was 636. Two years later—and this is surely a very good example of how the Government's housing policy is failing—on 1st January, 1950, the number was 630, in spite of a considerable building programme which that authority had carried out. Its allocation of houses for 1948 was 139, but it was unable to get contracts for a complete number, and, as a result, its allocation in 1949 was cut down to 20 houses. So far in 1950, its allocation has been cut down to 30 houses.
On the other hand—and this is what brought this point primarily to my notice—when I was sitting upstairs on a Committee on a Private Bill, I was surprised to learn that the great corporation promoting that Bill had, so far as its housing authority was concerned, no difficulty whatever in getting as many houses allocated as it could possibly build, and that there was no fear, so far as they were concerned, of being limited in their allocation—they were merely limited by the building resources available to them.
Reverting to my earlier point about need, the needs of the rural district council with which I am concerned were almost identical in 1948 and 1950, yet the allocation in 1948 was 139, whereas that in 1950 has been only 30. This simply does not make sense and I do not think that it is fair. Further, because of these great difficulties facing the country areas, this policy is preventing those who want a modest home of their own—and who are prepared to build it and to contribute fully to the rates in order, incidentally, to assist in subsidising council houses in the area and thus in keeping down the gross rents paid by those less able to build for themselves—from doing, what is a very important thing indeed from the point of view of the district councils concerned owing to the reduc-

tion in the allocation year by year. Thus, the problems of the country areas become more acute.
I do not know whether the Minister is prepared to reconsider the problems of these country areas, and, in particular, those of individual rural district councils, but I am sure it is urgent that he should do so. The need for housing is just as essential in the country areas as it is in the great cities and towns. All rural district councils should be dealt with and their housing allocations made on a different basis from those of the urban district councils and the boroughs. I think there would be great advantages in having the allocations for the rural district councils based on total expenditure allowed, rather than on the number of houses to be built. This would make for greater flexibility, particularly in the private enterprise section. I should much prefer to see built two houses costing £1,000 each than one costing £2,000. I am certain that with this greater freedom and with their knowledge of local needs and resources, the local authorities could make far greater progress in solving the housing problems of the country than is being made at the present time.
A further point I wish to raise concerns the time at which allocations are notified to the local authorities concerned. In the case of the rural district council which I have in mind, the allocation for 1950 was made on 13th April. They set about calling for tenders as quickly as they could, but obviously by the time those tenders are received and accepted and the contracts completed, a good part of the best summer building weather will be over. As a result of that, increased delay and expenditure will be involved in completing the houses. After that, the Minister will probably penalise the unfortunate rural district council concerned by reducing its allocation for next year.
I believe that anyone administering a housing programme should make certain that the allocation for each year is notified to local authorities by 1st January, and if a supplementary allocation can be provided later, so much the better. This is an example of administrative failure, and, in this case, of unfairness. The hon. Gentleman will recollect that on 4th May this year the Minister announced a reversion to the previous ratio of 4-1. The rural district council in question quite


properly readjusted its allocation accordingly, only to learn from the Minister's circular, 57/50, of 17th May, that the new ratio would only take effect in 1951. From the Questions asked in the House recently it is clear that this rural district council is not the only one concerned.
The new ratio should apply to allocations made after 4th March, 1950. Both from the point of view of administration and of local needs, this would be right and fair. But if the Minister does not feel he can apply it as far back as that, I think it would be right to say that any council which received its allocation within one month of the Minister's announcement of 4th May should be allowed to adopt the revised ratio as between private enterprise houses and council houses.
I have brought certain points to the attention of the House this afternoon, partly because I think there is a very grave danger of even the meagre housing programme, as we know it at present, failing to achieve a fair distribution of houses among the various localities concerned. But I have done so, particularly, because they are evidence which confirms one of the criticisms we have been making of the Minister and of his Ministry during the last five years or more—that it is not only his general policy that is wrong, but also that many of the difficulties we have seen result from bad administration in the Ministry.

4.16 p.m.

The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop): I am very grateful to the hon. Member for Colchester (Mr. Alport) for enabling me to be here to deal with the points he has raised this afternoon. Far from regretting it, I find it a pleasurable occasion, because it is quite clear that there is a great deal of misunderstanding about the administrative procedure of making housing allocations up and down the country, and it is desirable that we should have some understanding about how this work is done.
I should have thought that most hon. Members with contacts with local authorities, and, I hope, with some knowledge of the regional offices of the Ministry of Health, would have already got a fairly good general picture of this work. However, it is apparent that the hon. Member for Colchester has not that general impression, and I am very glad of this

opportunity of clearing up one or two points he has raised.
First, as a matter of general principle, it is, of course, quite wrong to suppose that the rural areas have suffered some disadvantages by too close attention being given to the needs of the big cities. That is very far from being the case. In point of fact, more houses have been built in relation to the population in rural areas than have been built in urban areas. Indeed, the contrast with the previous development of housing in rural areas is very striking throughout the country. It is utterly untrue to suggest that rural areas are under some special disabilities.
I quite realise the problems that arise in particular rural areas, such as difficulties about sites and about getting labour across to some particular place in a rural district. But the difficulties that face some of our bigger cities are much more clamant than that. In very many of our big cities, owing, in part, to the success of our vigorous industrial development at the present time, there are not the building workers available to do the work so urgently needed. It is, therefore, unfortunate that very often we are not able to develop as rapidly in our big cities as we should like to do. It is quite untrue to say that there is any sort of disproportionate effort as between urban and rural areas.
The main feature of our allocation procedure, is, of course, that it is essentially flexible, and takes account not only of one or two factors but of the whole wide range of local conditions that must be thought of in deciding what number of houses a local authority is to be allowed to build, and, in fact, is able to build. We have allocated to us nationally certain total resources available for house-building in the country as a whole, and the main issue we are concerned with in the Ministry is to ensure that all that available material and labour is fully used. It would obviously be a great tragedy if allocations were made to one area or another and were not fully used, with the result that we should not have achieved our objective of making the greatest possible use of the resources both in labour and material that were nationally available to us.
We split up the total national resources in terms of houses available to us as a


Ministry between the different regions of the country—the Ministry regions. These allocations are not final decisions. They are subject to amendment and alteration according to the progress made in the different regions, and take into account variations in the supply of material and labour. Once a region has been given its allocation for a year, well in advance of the building year, the problem of allocation to individual authorities is left to the principal regional officer, so that he can make his own arrangements in the most flexible way possible, to ensure that the resources available in the region are fully utilised throughout the year.
Obviously the regional officer, in making his allocation to all the large number of local authorities in his region, has to take account of a wide range of different factors. I will mention some of them. Obviously it is impossible in answer to Questions on the Floor of the House to deal with this matter in detail, but I imagine that some of the points that a regional officer must keep in mind will be apparent to every hon. Member.
First, he has to keep in mind, as mentioned this afternoon, the relative housing needs of the area, and we certainly do not regard the housing lists as necessarily an accurate estimate of the relative needs as between one district and another; but housing lists ale, of course, taken into account, among other matters. Then there is the question of population, and whether there has been bomb damage, and so on. These are all matters to be borne in mind.
There is also the question of the availability of building labour. There again, unless we take account of a matter like that, we shall be making allocations to an area which we know they cannot use, and that would deny other areas the opportunity of building. We naturally keep in touch very closely with the Ministry of Labour, who have a clear picture continuously of the building labour position. It is not merely a question of the total number of building trade workers available, but of assuring that we have a balanced team of building workers. That is a problem that arises in many areas where there may be a large amount of unskilled labour available but not the trained labour that we need as well.
As the hon. Member for Colchester mentioned, we must also take account of

the progress made by the authority in the area in the past. Unless we do that, we may be put in the position of making allocations that cannot be used, and, in fact, sterilising material that other areas urgently need. Therefore, we take account of the progress made, but we keep always in mind the possibility of change, because the position in an area does change very much from time to time. That is always kept in mind by the regional officers.
Some regional officers issue the whole allocation in advance of the actual building year. Others, keeping in mind the particular needs of their regions, make allocations in stages or "bites," because it may be that the local authority can only undertake a certain part of the work and may be able to take on the other part later in the year. The regional officers might keep in reserve a certain amount of the allocation to meet a case of that kind. We are, of course, encouraging local authorities to keep in close contact with our regional officers in order that any change in their position can be borne in mind and alterations made.
The other point we have to keep in mind is the availability of sites. That is much more of an issue in some areas than in others. Then we have the question of the special industrial needs of particular districts in regard to agriculture, mining or export industries. All this multiplicity of factors has to be borne in mind, and can only be looked at locally where the building has to be done. That is why we leave the greatest flexibility and opportunity for change in the hands of our principal regional officers. We find, very often, that complaints are made about allocations because it is not realised that allocations are sometimes made in stages, which is quite a reasonable thing for a regional officer to do.
Sometimes we find that a small allocation has been made because there is a large number of houses under contract or being built, and that no more houses can be built until those under construction are much further towards completion. The regional officer must keep in mind the actual stage of development of the housing work of a particular authority. I shall have to look into the individual case raised in more detail. I am not sure to which of the authorities in the


constituency of the hon. Member he is referring. It is frequently the case that an allocation may not be made until later in the year, for the reasons I have mentioned as, for example, that already there is a good deal of work in hand, either at the tendering stage or actually commenced, in which case the regional officer can perfectly fairly say to the local authority, "Let us see how the scheme is going forward before I commit the materials under my control. If the progress is good we shall then be able to discuss the matter further."
We not only encourage the local authorities to keep in contact with our regional officers, but our regional officers are keeping in contact with the local authorities by visiting them and, in some cases, attending meetings in the towns and villages concerned. In that way they are keeping in close contact with the work. I am sure that this flexibility of administration is highly desirable and essential if we are to secure the full use of the materials that are available.
As far as private licensing is concerned, we have already made some

alterations, as the House knows. We are only able to bring this into operation in regard to the 1951 allocation, because the 1950 allocation, by and large, has been issued and the houses are under construction or the work being put out to tender. It would be impossible, for that reason, to go back on the contracts that have been made, but where a local authority is not in that position we are prepared, as my right hon. Friend has said, to look into individual cases. In any case, our regional officers will be making the allocations in many areas quite shortly for the next year's building operations, to see if they can get all the preparatory work completed this year so that the building can commence at the earliest possible moment next year.

The Question having been proposed after Four o'Clock and the Debate having continued for half an hour, Mr. DEPUTY-SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at Twenty-nine Minutes to Five o'Clock.